Malignancy

• Head and neck cancer:

  • Cancer within the upper aerodigestive tract
  • Usually squamous cell carcinoma
  • All have potential to spread to lymph nodes - initial presentation can be lymphadenopathy
  • Have common non-specific symptoms: weight loss, night sweats, anorexia
• Salivary cancers tend to be adenocarcinomas
• Investigations:

  • Flexible nasoendoscopy or laryngoscopy allows direct visualisation of lesions and biopsy
  • If patients only have lymphadenopathy - USS guided fine needle aspiration
• Imaging:

  • MRI head and neck = imaging of choice to assess local extent of cancer
  • CT neck and chest - tumour extension, local invasion, spread to lymph nodes and lungs
  • PET CT - identify metastatic disease
• Treatment may involve any combination of:

  • Chemotherapy
  • Radiotherapy
  • Surgery
  • Targeted drugs e.g. Cetuximab
  • Cetuximab - monoclonal antibody used for treatment squamous cell carcinomas of the head and neck - targets epidermal growth factor receptor