Adult Neck masses Flashcards
(30 cards)
WHat type of cancer is found in the superior jugular chain?
Mets from nasopharynx
WHat type of cancer is found in the lower jugular chain?
MEts from thyroid, piriform sinus, upper esophagus
WHat type of cancer is found in the Mid jugular chain?
Mets from oral cavity, pharynx or larynx (Waldeyer’s tonsillar ring)
WHat type of cancer is found in the Posterior Triangle?
Mets from nasopharynx, post scalp, ear, temporal bone, or skull base
WHat type of cancer is found in the submandibular triangle?
Mets from anterior 2/3 of tongue, floor of mouth, gums, mucosa of cheek
WHat type of cancer is found in the submental Triangle?
Cancer of Lip rarely involved early
What are risk facors for Head and NEck cancer?
Chronic Sun exposure Tobacco and alcohol Poor dentition Industrial/envt exposure FHx
What are the Sx of H/N Cancer?
Non-healing ulcer of mouth Persistent sore throat Dysphagia Change in voice Recent weight change Ear pain w/ normal ear exam
WHat diagnostic tests are done on head and neck cancers?
Fine needle aspiration Computer Tomography MRI US Radionucleotide scanning
What are the indications for fine needle biopsy?
Any neck mass that isn’t an obvious abcess
Persistence after Abtx
Progressive growth, supraclavicular
Anx sx of lymphoma
What are the contraindications of Fine needle biopsy?
Near carotid artery?
US Guidance?
What are good tips for FNAB?
Proper Collection
Min of 4 passes
Skilled cytopathologist essential
On-site review best
What are the traits of Computed Tomography in H/N Cancers?
Distinguish cystic from solid Ext of lesion Vascularity Detection of unkn 1^ tumor Pathologic Node Avoid contrast in THyroid lesions
What are the considerations of MRI in H/N Cancers?
Similar info as CT
Better for upper neck and skull base
Vasc delineation w/ infusion
What are the considerations of US in H/N Cancers?
Less important now w/ FNAB
Solid vs cystic
Congenital cysts from solid nodes/tumors
Non-invasive
What are the considerations of Radionucleotide Scanning in H/N Cancers?
Salivary and thyroid masses
Loc-Gland vs Extra-Gland
Funct info
What is the Workup procedure for Nodal mass workup in the adult?
Any solid asymmetric Mass
Ips otalgia w/ normal otoscopy => attn to tonsil, tongue base, supraglottis and hypopharynx
Uni serous otitis => Examine nasopharynx
When is Open excisional Biopsy done?
Complete Workup (-) Complete neck dissection? Frozen section? -Inflamm or Gran- Cuture -Lymphoma or Aden CA- Close wound
What is the most common neoplastic condition in children?
Thyroid mass
What is the Dx test used for Thyroid Mass?
FNAB
What are the Sx of Lymphoma?
Lateral neck mass
Fever
Hepatosplenomegaly
Diffuse adenopathy
Where is a mass usually found in Hodgkin’s lymphoma?
Neck mass
What are the traits of Benign vs Malignant Salivary Gand tumors?
Enl mass ant/inf to ear or at the mandibular angle
Ben: Asympt except for mass
Mal: Rapid Growth, skin fixation, CN palsy
What are the traits of Carotid Body Tumors?
Rare in children
Pulsitile compressible mass
Mobile med/lat, not sup/inf
