Head and Neck CA

Question 1

Non-healing ulcer/ sore
Loosening of teeth or ill-fitting dentures
Dysphagia/ Odynophagia
Wt loss
Bleeding
Referred otalgia
Neck mass
Are all ssx of what cancer

Answer 1

Oral Cavity Cancer

Question 2

Neck mass
Chronic serous otitis media
Pain
Are all ssx of what cancer

Answer 2

Nasopharynx Cancer

Question 3

Chronic sore throat
Referred otalgia
Late sx - change in voice/ hoarseness, dysphagia, trismus (locked jaw)
Are all ssx of what cancer

Answer 3

oropharynx cancer

Question 4

Patients often remain asymptomatic for a long period
presenting complaints - pain, bleeding, neck mass
are all ssx of what cancer

Answer 4

posterior pharyngeal wall cancer

Question 5

70-80% of pts have clinically involved cervical nodes at the same time of diagnosis - ssx of what cancer

Answer 5

hypopharynx cancer

Question 6

usually dx late stage can present with airway obstruction and neck mass due to lymphadenopathy =

Answer 6

supraglottic cancer

Question 7

often causes sx early:
persistent hoarseness
dysphagia
referred otalgia
chronic cough
hemoptysis
stridor =

Answer 7

glottic laryngeal

Question 8

Over 60% of pts with head and neck cancer present with

Answer 8

cervical lymphadenopathy

Question 9

Head and Neck CA is dx by

Answer 9

bx

Question 10

Refer immediately to ____ if Head/Neck CA suspected

Answer 10

EENT

Question 11

Testing for Head/Neck CA can include:

Answer 11

Panendoscopy (laryngoscopy, Bronchoscopy, Esophagoscopy)
CT or MRI
PET scan
CBC, LFTs, CMP

Question 12

Neck Mass DDX

Answer 12

congenital - Branchial cleft cyst, thyroglossal duct cyst, vascular abnormalities
Infectious/ inflammatory
Malignant

Question 13

Branchial Cleft Cysts are

Answer 13

by the 5th week of pregnancy these “gills” should go away but when they don’t they form this
located right below the ear or anterior to the sternocleidomastoid muscle

Question 14

Thyroglossal duct cyst is located

Answer 14

superior of cricoid cartilage, inferior of hyoid bone

Question 15

if infection is unlikely, mass doesn’t resolve, or mass recurs ___________ is required

Answer 15

further workup

Question 16

first imaging study =

Answer 16

CT

Question 17

staging for head/neck cancer

Answer 17

TNM staging
Tumor
nodes
mets

Question 18

Early stage treatment (stage 1 & 2)
small localized disease without nodal involvement

Answer 18

treat with either surgery or radiation

Question 19

Locally advanced (high risk for local recurrence)

Answer 19

chemo is gold standard
surgery reserved to preserve organ function

Question 20

Early stage head and neck CA prognosis

Answer 20

70-90% survival

Question 21

Late stage head and neck CA prognosis

Answer 21

30-60% survival

Question 22

Late stage head and neck CA prognosis

Answer 22

30-60% survival

Question 23

Cancers due to HPV appear to have a better

Answer 23

prognosis

Question 24

Head and Neck CA prevention vaccines

Answer 24

HPV (Gardisil, Gardisil 9, Cervarix)

Question 25

Leukoplakia =

Answer 25

Premalignant lesion white patch on oral mucosa that cannot be scraped off bx is needed - 20% develop into invasive cancer in

Question 26

Leukoplakia =

Answer 26

Premalignant lesion white patch on oral mucosa that cannot be scraped off bx - precancerous 20% develop into invasive cancer in 10 years

Question 27

Erythroplakia =

Answer 27

red patch on the oral mucosa dx - precancerous more likely than leukoplakia to become malignant or have an invasive component (30-50%)

Question 28

Hairy Leukoplakia =

Answer 28

EBV induced lesion always HIV infected or immunocompromised pts NOT a premalignant lesion painless white patch - often tx is not needed

Question 29

Nasal/ Paranasal CA is _____ and is more common in _____

Answer 29

rare men ~ 60-65 yo

Question 30

Most common site of Nasal/ Paranasal CA

Answer 30

maxillary sinus second - ethmoid sinus

Question 31

Nasal/ Paranasal CA ssx

Answer 31

pain nasal obstruction epistaxis chronic sinus congestion hyposmia/ microsmia*

Question 32

Nasal/ Paranasal CA dx you need a

Answer 32

bx workup - CT, endoscopy, MRI

Question 33

Nasal/ Paranasal CA dx you need a

Answer 33

bx workup includes - CT, endoscopy, MRI

Question 34

Nasal/ Paranasal CA are usually related to

Answer 34

occupational exposures

Question 35

Nasal/ Paranasal CA staging

Answer 35

TNM staging most do NOT have lymph node involvement

Question 36

most Nasal/ Paranasal CA do NOT have ________

Answer 36

lymph node involvement

Question 37

80+% of Nasal/ Paranasal CA have ______ invasion

Answer 37

bony

Question 38

Nasal/ Paranasal CA treatment

Answer 38

surgery and radiation

Question 39

Salivary gland tumors are most common in

Answer 39

80-85% = parotid gland, 80% = benign tumors in other salivary glands more likely to be malignant

Question 40

Nasal/ Paranasal CA prognosis

Answer 40

overall poor T1 = 50% and the further you go the further it drops