CARCINOMAS OF

THE HEAD AND

NECK

BY
REEM TAHIR
1st YEAR BDS
INTRODUCTION
 TUMOR:
A new growth of tissue in which multiplication of cells is
uncontrolled and progressive.
 TYPES OF TUMOR:
• Benign Tumor
It lacks the properties of invasion and metastasis and it is
usually surrounded by a fibrous capsule;its cells also show a
lesser degree of anaplasia than those of malignant tumors. For
example: lymphangioma,hemangioma&adenolymphoma
Malignant Tumor
It has the properties of invasion and metastasis and it shows a
greater degree of anaplasia than do benign tumors. For
example: Breast cancer, carcinoma of uterus,etc
It consists of two types: sarcoma & carcinoma
CARCINOMA

 Carcinoma is defined as malignant

neoplasm of epithelial cell origin derived
from any of the three germ layers of the
epithelium.
 It tends to infiltrate the surrounding
tissues and give rise to metastasis.
 COMMON PATHOLOGICAL TYPES OF
CARCINOMA IN THE HEAD & NECK

 Squamous Cell Carcinoma (most common

malignancy of head & neck region)
 Adenocarcinoma
 Basal Cell Carcinoma
 Adenoid Cystic Carcinoma
 Mucoepidermoid Carcinoma
Carcinoma of the Tongue and floor of mouth
Basal Cell Carcinoma of Face
COMMON SITES OF CARCINOMA IN
THE HEAD & NECK REGION

 Oral Cavity
 Nasopharynx
 Oropharynx
 Hypopharynx
 Larynx
 Thyroid Gland
 Paranasal Sinuses
 Salivary Glands
 Skin
Carcinoma Of the Parotid
Gland
Carcinoma of the
Submandibular Gland
Normal Vocal Cords

ORAL CAVITY AT A
GLANCE
Carcinoma of Larynx Obliterating
the airway causing stridor
ETIOLOGY & RISK FACTORS

 Smoking
 Alcoholism
 Tobacco chewing
 Radiation Exposure
 Wood Dust
 Foods containing nitrosamines
 Avitaminosis
 Dental Sepsis
 Jagged sharp teeth
 Ill-fitting dentures
PRE MALIGNANT LESIONS

 Leukoplakia
 Erythroplakia
 Melanosis & Mucosal hyperpigmentation
 Odontogenic tumors
ROLE OF SITE OF TUMOR IN
CARCINOMA
 Presentation depends on the site of the tumor
 Larynx
 Hoarseness of voice and difficulty in breathing
 Oral Cavity & Oropharynx
 Leukoplakia,Ulcers & Fetor oris /halitosis
 Nasopharynx
 Cervical lymphadenopathy and epistaxis
 Hypopharynx
 Dysphagia & Otalgia
 Paranasal Sinuses
 Nasal Obstruction and epistaxis
 Salivary and Thyroid Gland
 Swelling over face and neck
Patient with Carcinoma of nasopharynx presented with
cervical lymph adenopathy and endoscopic view of the
tumor in the post nasal space
Carcinoma of the Left Tonsil
Carcinoma in the nasal cavity
seen through an endoscope
DIAGNOSTIC CRITERIA
 Complete history of patient
 Complete Head & Neck Examination
 Radiological Investigations to ascertain the extent of the
Disease
 Plain Radiographs
 Barium studies
 CT scan for bony extension
 MRI for soft Tissue Spread
 Ultrasonography for cervical metastasis and distant
spread
 Lesions of oral cavity and nose are biopsied under
topical anaesthesia
 Endoscopic examination and biopsy is done for
carcinomas of larynx,oropharynx and hypopharynx
CT SCAN SHOWING LEFT
GLOTTIC CARCINOMA
Cross Sectional Picture Showing
The Paranasal Sinuses
MRI of paranasal sinuses showing
Carcinoma of ethmoids extending into
brain
Direct Laryngoscopy for evaluation and biopsy
of laryngeal Carcinomas
Endoscopic Examination of the
nasal cavity and nasopharynx
TREATMENT OPTIONS &
MANAGEMENT
 Radiotherapy

 Chemotherapy

 Surgery

 Supportive care for advanced stage carcinomas

 Pain Relief
 Feeding
SURGICAL TECHNIQUES

 Block Dissection (if cervical nodes are

positive)
 Wedge resection (for early lesions)
 Marginal or segmental mandibular
resection
 Radical parotidectomy
RECONSTRUCTION

 Tumor resection in the head and neck

produces cosmetic and functional
defects that needs prosthetic or
reconstructive surgery.
 Options For Reconstruction
 Local Flaps
 Distant Flaps
 Free Flaps
TUMOR OF THE LIP
EXCISION OF THE TUMOR
Reconstruction With Local
Flap
Patient 3 Months after surgery
 CONCLUSION

 Carcinomas of the head & neck region

pose a significant challenge as regards
to early diagnosis , treatment and
reconstruction. A multidisciplinary
approach is adapted to deal with these
tumors.
THANK
YOU