Malignancies of the Jaw

Question 1

Examples of Malignant Lesions

Answer 1

1. SCC
2. Basal cell carcinoma
3. Karposi sarcoma
4. T cell lymphoma
5. Oral melanoma

Question 2

What is the prognosis of SCC?

Answer 2

5 year survival is 45-50%. Poor

Question 3

Tumours of oropharynx are linked to?

Answer 3

Oncogenic strains of HPV 16 and 18

Question 4

Predisposing Factors of SCC?

Answer 4

1. Tobacco, excessive alcohol, betel nut chewing
2. HPV or EBV infection
3. UV exposure
4. Exposure to environmental pollutants

Question 5

SCC is derived from?

Answer 5

Mucosal epithelium of oral cavity and pharynx

Question 6

What are examples of premalignant lesions?

Answer 6

Leukoplakia

Erythroplakia

Actinic cheilosis

Erosive lichen planus

Question 7

Where does SCC metastasize to?

Answer 7

Lymph nodes

Question 8

What are the common site of lymph node metastasis?

Answer 8

1. Preauricular and parotid nodes
2. Peri-auricular nodes and suboccipital nodes
3. Retropharyngeal nodes

Question 9

What is the etiology of Basal Cell Carcinoma?

Answer 9

Chronic exposure to UV radiation

Basal layer of epithelium proliferates and invade into underlying tissue

Question 10

Prognosis of melanoma?

Answer 10

5 year survival 45%. Poor

Question 11

Where does melanoma metastasize to?

Answer 11

Lymph nodes then blood

Question 12

Treatment of Melanoma

Answer 12

Surgical wide excision + Nearby lymph nodes + Immunotherapy

Question 13

Types of treatment for head and neck cancer

Answer 13

1. Surgery
2. Radiation
3. Chemotherapy
4. Targeted therapy

Question 14

Where can skin graft be taken from?

Answer 14

Radial forearm flap

Question 15

What is used to treat oropharyngeal cancer?

Answer 15

External beam radiation therapy given as daily fractions 5 days a week for 7 weeks

Question 16

Side effects of Radiotherapy

Answer 16

1. Soreness in mouth or throat
2. Dry mouth
3. Dysphagia
4. Change in taste
5. Nausea
6. Caries

Question 17

What is adjuvant chemotherapy?

Answer 17

Given after surgery to kill cancer cells that may be left behind

Question 18

What is neoadjuvant chemotherapy?

Answer 18

Given before surgery to shrink some larger tumours

Question 19

What is the other purpose of chemotherapy?

Answer 19

For stage 4 cancers which had spread too far to be removed by surgery. Slow the growth of cancer

Question 20

What is chemoradiation?

Answer 20

Chemotherapy given at same time as radiation

Targeted drug cetuximab is often used with radiation