Throat Malignancy Flashcards
Where is the most common site of head and neck cancer
The larynx
What is the most common tumour if the head and neck
Squamous cell carcinoma
Name some factors that have been linked to SSC
Smoking, alcohol, HPV type 16
Name some other types of head and neck cancers
Nasopharyngeal, laryngeal, oropharyngeal and oral cavity carcinoma
Where is nasopharyngeal carcinoma commonly seen
South china
What is nasopharyngeal carcinoma linked to
EBV
What is oropharyngeal cancer commonly associated to in the west
HPV
Where is oral cavity carcinoma commonly seen
South Asia
What has oral cavity carcinoma been linked to
Chewing tobacco
What is the typical patient group for head and neck cancer
Male, >55 with long exposure to smoking and alcohol
Who usually presents with HPV related OP SSC
Non-smoker, higher socio-economic class, multiple sexual partners
How do well differentiated SSC look
Epithelial cells with keratinisation and prickle cells
What is the characteristic spread of supraglottic tumours
drain to superior deep cervical nodes
Where do glottic tumours spread to
Usually stay on the chords (95%)
Where do subglottic tumours spread to
Paratracheal nodes
How do glottic and subglottic tumours present
Voice changes and airway obstruction
How does head and neck cancer present
Dysphonia
Progressive dysphasia
Odynophagia
Unilateral otalgia
Neck lump
Airway obstruction- Stridor
What is odynophagia
Painful swallowing
Initial investigation of head and neck cancer
Ultrasound and fine needle aspiration
Confirmatory investigation of head and neck cancer
Panendoscopy and biopsy under general
Management of early laryngeal cancer
Transoral laser surgery, radiotherapy
Management of advanced laryngeal cancer
Partial or total laryngectomy, chemo and radiotherapy
Management of early oropharyngeal cancer
Transoral laser surgery, radiotherapy
Management of advanced oropharyngeal cancer
Chemo and radiotherapy
Management of nasopharyngeal cancer
Radiotherapy and chemotherapy
What is a paraganglioma
Tumour arising from clusters of neuroendocrine cells
When do paragangliomas usually arise
> 50
Name some genetic syndromes linked to paragangliomas
MEN2, von Hippel-Lindau syndrome, neurofibromatosis type 1
Most common genetic cause of hereditary paragangliomas
Mutations in the succinct dehydrogenase subunit
Where do sympathetic paragangliomas usually arise
Below the level of the neck
What are parasympathetic paragangliomas usually related to
Great vessels of the head and neck
Histology of paragangliomas
Nests of round/oval cells surrounded by delicate vascular septae
How do sympathetic paragangliomas present
Features of catecholamie excess
Headaches, palpitations, diaphoresis and hypertension
What is diaphoresis
Excessive sweating
How do parasympathetic paragangliomas usually present
Mass effects
Cranial nerve palsies, neck mass, tinnitus
Imaging paragangliomas
CT, MRI, MIBG, PET
Management of paragangliomas
Surgical resection or radiotherapy
