Week 3: Oropharyngeal Carcinoma

Question 1

42yo Asian M is evaluated by his otolaryngologist for a R-sided upper neck mass. The mass is non-painful and has been enlarging for the last several months. He has no other symptoms. FNA is shown in the image. EBV is positive. Where is the most likely location of the patient’s primary disease?

A. Tonsil
B. BOT
C. Piriform sinus
D. Tail of parotid
E. Fossa of Rosenmuller

Answer 1

Fossa of Rosenmuller.

(This image demonstrates metastatic nasopharyngeal carcinoma - notice clumps of syncytial cells, prominent nucleoli, and ill-defined cytoplasm).

Question 2

The 3 types of nasopharyngeal carcinoma include:

1.
2.
3.

With up to 75% of patients having type ___.

Answer 2

The 3 types of nasopharyngeal carcinoma include:

1. SCCa
2. non-keratinizing epidermoid carcinoma
3. non-keratinizing undifferentiated

With up to 75% of patients having type Type 3.

Question 3

Nasopharyngeal carcinoma (NPC) is related to ___, diet (salted fish), and undifferentiated NPC has been linked to EBV.

Answer 3

Nasopharyngeal carcinoma (NPC) is related to genetics, diet (salted fish), and undifferentiated NPC has been linked to EBV.

Question 4

Nasopharyngeal carcinoma (NPC) is related to genetics, _____, and undifferentiated NPC has been linked to EBV.

Answer 4

Nasopharyngeal carcinoma (NPC) is related to genetics, diet (salted fish), and undifferentiated NPC has been linked to EBV.

Question 5

Nasopharyngeal carcinoma (NPC) is related to genetics, diet (salted fish), and undifferentiated NPC has been linked to ___.

Answer 5

Nasopharyngeal carcinoma (NPC) is related to genetics, diet (salted fish), and undifferentiated NPC has been linked to EBV.

Question 6

Per NCCN guidelines for occult primary tumor of the head & neck, a neck node in levels I-III containing adenocarcinoma w/negative staining should undergo _____.

Answer 6

Per NCCN guidelines for occult primary of the head & neck, a neck node in levels I-III containing adenocarcinoma w/negative staining should undergo neck dissection w/w/o parotidectomy.

Question 7

For a N2 LN containing SCCa, poorly differentiated/non-keratinizing SCCa, ___ is the preferred treatment modality.

Answer 7

For a <N2 LN containing SCCa, poorly differentiated/non-keratinizing SCCa, surgery is the preferred treatment modality.

Question 8

In reference to the H&N:

Osteosarcoma occurs most commonly in the ___ and ___.

Answer 8

Maxilla and Mandible

Question 9

In reference to the H&N:

Liposarcomas occurs most commonly in the ___.

Answer 9

Neck

Question 10

In reference to the H&N:

Chondrosarcomas occurs most commonly in the ___.

Answer 10

Larynx

can also be clivus, petrous temporal bone, maxilla, and mandible

Question 11

In reference to the H&N:

Synovial sarcomas occurs most commonly in the ___.

Answer 11

Hypopharynx

arise from pluripotent mesenchymal cells