Professional Documents
Culture Documents
Head & Neck Tumors
Head & Neck Tumors
ANYA DYOSANG PIPAY FAIFAI WEB JOJO ARLS JESS AYKI JAM KRISETTE ELYSSE KEKE KARING MIKKO YEL EM BOK SHENG ANNE KRISTINE KUKIS CYNTHIA
KIWI NATHAN MIGGY MAYEE MACOY BONI ROD JEANS KATHY PENG BABY JI HOO CHACHA JAJA DEE AILA JERMIE CATH OJ MAI POYENG DET ELAINE
FAYE REUBEN LULU LELE YIMMY LEE THEA JEN MEYMEY DIA ANNE CRISTINE MAIKA MARC GELIQ DOP BEDA YEN
Medical Therapeutics
MALIGNANT HYPERTHERMIA
Page 2 of 4
Provides information on the location of the 4. Supraclavicular nodes – lung, GIT, GUT
mass whether nodal or glandular
Provides info on the vascularity of the mass SPECIFIC NECK MASSES
(with infusion) I. Primary neoplastic neck masses
Nodal malignancy – lucency, size, indistinct
border 1. THYROID NEOPLASM
Anterior compartment masses
ULTRASONOGRAPHY PATTERN In children/young adults – most common,
1. Complex pattern with male preponderance & higher incidence
Differentiate abscess or necrotic tumor of malignancy
clinically In older age group – has female
2. Cystic preponderance and mostly benign
Differentiate lymphoma and hyperplastic Lymph node metastases
node by A-mode testing or aspiration o 15% initial symptoms in papillary Ca
3. Solid o 40% of malignancies have nodes
Differentiate crystalline or colloid cyst by A- when operated
mode pattern or aspiration (90-95% accurate) Tests:
o Scan/UTZ
BASIC PATTERN o FNA
1. Undiagnosed neck masses in an adult are metastatic
carcinoma until proven otherwise 2. SALIVARY NEOPLASM
a. According to the study of Martin & Romies – neck Consider any preauricular or angle of
mass is the first symptom in CA in 12% of 1300 mandible mass until proven otherwise
cases Benign masses are asymptomatic
b. Accdg to Hayes Martin – asymmetric enlargement Malignant if there is/are:
of one or more cervical lymph nodes in an adult is o Rapid growth
almost always cancerous and is visually due to o Nerve palsy
metastases from a primary lesion in the mouth or o Skin fixation
pharynx Tests:
c. Results of 163 lymph node biopsies o Scan – little help in dx
29.4 % epidermoid CA o Sialography –helps in locating the
21.4% lymphoma or hodgkins mass
10.1% benign hyperplasia
2. Excisional biopsy of a mass in an adult prior to a 3. CAROTID BODY TUMOR
complete head and neck evaluation is contraindicated During PE
Primaries foung on the initial examination o There is presence of thrill bruit
o Memorial – 218 patients – 65% o Compressible refills
o MD Anderson – 259 patients – 52% o Moves side to side NOT up and down
Diagnosis – ARTERIOGRAM
FNA APPLICATION o Demonstrate a characteristic highly
1. Anterior compartment thyroid mass treatment vascular mass at the carotid
decision bifurcation
2. Differentiate cystic from solid lesions Found in older age groups
3. Confirm metastases from distant known primaries Elevates and moves with the skin
4. Establish diagnosis in non-surgical head and neck
patient 4. BRACHIAL CLEFT CYST
5. Allay patient fear of cancer – aloows informed
Onset: late childhood or early adulthood and
observation of hyperplastic nodes
follows upper respiratory infection
6. Differentiates carcinoma from lymphoma – prevents
Location: anterior triangle of the neck
endoscopy
Tests: UTZ – cyst
TX:
GUIDED BIOPSY SITES
o Control initial infection
1. Posterior cervical nodes – nasopharynx
o Avoid incision and drainage
2. High and mild jugular nodes – tonsil
3. Mild jugular nodes – tongue base, pyriform sinus o Total tract incision
o
Medical Therapeutics
MALIGNANT HYPERTHERMIA
Page 3 of 4
ADENOPATHY IN PATIENTS
1. Rapidly enlarging nodes
2. Tender nodes
3. Nodal enlargement with systemic symptoms
Traumatic Masses:
a. Pseudoneurysm
b. Neuroma
c. Fibroma
SUMMARY
1. Inflammatory masses – trial of antibiotics if there is
persistence of growth then do excision after work-up
2. Pediatric – biopsy only if:
a. Progressive growth
b. Isolated or asymmetric node
c. Supraclavicular mass
d. Adenopathy with systemic symptoms or non-nodal
lymphoid enlargement (tonsil, liver, spleen)
3. Adult – only after complete head and neck work-up
4. FNA initially:
FNA (+) for CA: endoscopy + guided biopsy excision
prepared for neck dissection.
__________________________________