Throat Malignancy Flashcards

1
Q

Where is the most common site of head and neck cancer

A

The larynx

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2
Q

What is the most common tumour if the head and neck

A

Squamous cell carcinoma

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3
Q

Name some factors that have been linked to SSC

A

Smoking, alcohol, HPV type 16

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4
Q

Name some other types of head and neck cancers

A

Nasopharyngeal, laryngeal, oropharyngeal and oral cavity carcinoma

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5
Q

Where is nasopharyngeal carcinoma commonly seen

A

South china

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6
Q

What is nasopharyngeal carcinoma linked to

A

EBV

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7
Q

What is oropharyngeal cancer commonly associated to in the west

A

HPV

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8
Q

Where is oral cavity carcinoma commonly seen

A

South Asia

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9
Q

What has oral cavity carcinoma been linked to

A

Chewing tobacco

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10
Q

What is the typical patient group for head and neck cancer

A

Male, >55 with long exposure to smoking and alcohol

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11
Q

Who usually presents with HPV related OP SSC

A

Non-smoker, higher socio-economic class, multiple sexual partners

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12
Q

How do well differentiated SSC look

A

Epithelial cells with keratinisation and prickle cells

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13
Q

What is the characteristic spread of supraglottic tumours

A

drain to superior deep cervical nodes

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14
Q

Where do glottic tumours spread to

A

Usually stay on the chords (95%)

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15
Q

Where do subglottic tumours spread to

A

Paratracheal nodes

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16
Q

How do glottic and subglottic tumours present

A

Voice changes and airway obstruction

17
Q

How does head and neck cancer present

A

Dysphonia
Progressive dysphasia
Odynophagia
Unilateral otalgia
Neck lump
Airway obstruction- Stridor

18
Q

What is odynophagia

A

Painful swallowing

19
Q

Initial investigation of head and neck cancer

A

Ultrasound and fine needle aspiration

20
Q

Confirmatory investigation of head and neck cancer

A

Panendoscopy and biopsy under general

21
Q

Management of early laryngeal cancer

A

Transoral laser surgery, radiotherapy

22
Q

Management of advanced laryngeal cancer

A

Partial or total laryngectomy, chemo and radiotherapy

23
Q

Management of early oropharyngeal cancer

A

Transoral laser surgery, radiotherapy

24
Q

Management of advanced oropharyngeal cancer

A

Chemo and radiotherapy

25
Q

Management of nasopharyngeal cancer

A

Radiotherapy and chemotherapy

26
Q

What is a paraganglioma

A

Tumour arising from clusters of neuroendocrine cells

27
Q

When do paragangliomas usually arise

A

> 50

28
Q

Name some genetic syndromes linked to paragangliomas

A

MEN2, von Hippel-Lindau syndrome, neurofibromatosis type 1

29
Q

Most common genetic cause of hereditary paragangliomas

A

Mutations in the succinct dehydrogenase subunit

30
Q

Where do sympathetic paragangliomas usually arise

A

Below the level of the neck

31
Q

What are parasympathetic paragangliomas usually related to

A

Great vessels of the head and neck

32
Q

Histology of paragangliomas

A

Nests of round/oval cells surrounded by delicate vascular septae

33
Q

How do sympathetic paragangliomas present

A

Features of catecholamie excess
Headaches, palpitations, diaphoresis and hypertension

34
Q

What is diaphoresis

A

Excessive sweating

35
Q

How do parasympathetic paragangliomas usually present

A

Mass effects
Cranial nerve palsies, neck mass, tinnitus

36
Q

Imaging paragangliomas

A

CT, MRI, MIBG, PET

37
Q

Management of paragangliomas

A

Surgical resection or radiotherapy