Head and neck cancer - Acute
Definition
Malignant tumors that arise from the lip and oral cavity, oropharynx, hypopharynx, larynx, nasal cavity, paranasal sinuses, nasopharynx, and salivary glands
Medical History
* Tobacco user
* Alcohol use
* Chewing or ingestion of substances
* Nasopharyngeal irritation
* Human papilloma virus infection
* Epstein-Barr virus infection
* Alaskan
* Asian
* Black or African American
Findings
* Pain
* Unexplained weight loss
* Mass of neck
* Otalgia
* Leukoplakia
* Inflamed tonsils
* Bleeding
* Trismus
* Pain in throat
* Stridor
* Dysarthria
* Hoarse
* Dysphagia
Tests
MRI of head or neck is indicated in the initial evaluation of tumors of the ethmoid sinus, maxillary sinus, or salivary gland and cancers of the oropharynx, hypopharynx, glottic and supra glottic larynx, and nasopharynx and as indicated for cancer of the lip and oral cavity
* MRI of head
Alternative to MRI of head or neck in the initial evaluation of tumors of the ethmoid sinus, maxillary sinus, or salivary gland and cancers of the oropharynx, hypopharynx, glottic and supra glottic larynx, and nasopharynx and as indicated for cancer of the lip and oral cavity
* CT of head
Initial work-up of cancer of the ethmoid sinus, maxillary sinus, cancer of the lip, or an occult primary tumor and an option to chest CT for cancer of the oral cavity, oropharynx, hypopharynx, glottic or supraglottic larynx, or nasopharynx
* Plain chest X-ray
Differential Diagnosis
* Oral candidiasis
* Lichen planus
* Mucous retention cyst of minor salivary gland
* Leukedema of mouth
Treatment
Drug Therapy
Primary systemic therapy with concurrent radiation therapy for squamous cell cancers of the head and neck cancer excluding nasopharynx
CISPLATIN
Primary therapy with concurrent radiation therapy for cancer of the nasopharynx
CISPLATIN
Adjuvant chemotherapy for cancer of the nasopharynx
CISPLATIN
FLUOROURACIL
Procedural Therapy
Head and neck cancer
* Surgical procedure: Larynx preservation surgery or chemoradiation is recommended for T3 or T4 tumors that do not extend through cartilage into soft tissue. A total layngectomy usually is recommended if soft-tissue extension is discovered .
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