Chapter 14: Head and Neck Cancers

Epidemiology

Pathology

1. Squamous carcinomas (90%)

2. Lymphomas

3. Salivary gland tumors (adenocarcinoma, adenoid cystic carcinoma, mucoepidermoid carcinoma)

4. Sarcomas

5. Melanomas

Work-up

1. History and physical examination

2. ENT examination

3. Laryngoscopy with biopsy of suspicious lesions

4. CT and/or MRI of the head and neck

5. X-ray or CT of chest (to rule out metastatic disease or second primary tumor)

6. Needle biopsy of lymph node not associated with obvious primary tumor

Organ Site Specific Work-up

1. Ethmoid sinus: H&P, CT and/or MRI, CXR, pathology review if diagnosis with incomplete excision

2. Maxillary sinus: H&P, Head and neck CT with contrast ± MRI, CXR, dental/prosthetic consultation as indicated

3. Salivary glands: H&P, CT/MRI, CXR, pathology review

4. Lip, oral cavity: H&P, CT/MRI, parorex, biopsy, preanesthesia studies, dental evaluation

5. Hypopharynx: H&P, biopsy, CXR or chest CT, CT with contrast or MRI of primary and neck, examination under anesthesia with laryngoscopy/esophagoscopy, preanesthesia studies, dental evaluation, multidisciplinary consultation as indicated

6. Glottic larynx: Same work up as for hypopharynx + CT scan with contrast and thin cuts of the larynx or MRI of primary, speech and swallowing studies

Staging