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CARCINOMAS OF

THE HEAD AND

NECK

BY

REEM TAHIR

1st YEAR BDS

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INTRODUCTION

TUMOR:

A new growth of tissue in which multiplication of cells isuncontrolled and progressive.

TYPES OF TUMOR:

Benign TumorIt lacks the properties of invasion and metastasis and it isusually surrounded by a fibrous capsule;its cells also show alesser degree of anaplasia than those of malignant tumors. Forexample: lymphangioma,hemangioma&adenolymphoma

Malignant Tumor

It has the properties of invasion and metastasis and it shows agreater degree of anaplasia than do benign tumors. Forexample: Breast cancer, carcinoma of uterus,etc

It consists of two types: sarcoma & carcinoma

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CARCINOMA

Carcinoma is defined as malignant

neoplasm of epithelial cell origin derived

from any of the three germ layers of theepithelium.

It tends to infiltrate the surrounding

tissues and give rise to metastasis.

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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

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Carcinoma of the Tongue and floor of mouth

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Basal Cell Carcinoma of Face

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COMMON SITES OF CARCINOMA IN

THE HEAD & NECK REGION

Oral Cavity

Nasopharynx

Oropharynx Hypopharynx

Larynx

Thyroid Gland

Paranasal Sinuses

Salivary Glands

Skin

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Carcinoma Of the Parotid

Gland

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Normal Vocal Cords

ORAL CAVITY AT AGLANCE

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Carcinoma of Larynx Obliterating

the airway causing stridor

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ETIOLOGY & RISK FACTORS

Smoking

Alcoholism

Tobacco chewing Radiation Exposure

Wood Dust

Foods containing nitrosamines

Avitaminosis

Dental Sepsis

Jagged sharp teeth

Ill-fitting dentures

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PRE MALIGNANT LESIONS

Leukoplakia

Erythroplakia

Melanosis & Mucosal hyperpigmentation

Odontogenic tumors

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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

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Patient with Carcinoma of nasopharynx presented with

cervical lymph adenopathy and endoscopic view of the

tumor in the post nasal space

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Carcinoma in the nasal cavity

seen through an endoscope

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DIAGNOSTIC CRITERIA

Complete history of patient

Complete Head & Neck Examination

Radiological Investigations to ascertain the extent of theDisease Plain Radiographs

Barium studies

CT scan for bony extension

MRI for soft Tissue Spread

Ultrasonography for cervical metastasis and distantspread

Lesions of oral cavity and nose are biopsied undertopical anaesthesia

Endoscopic examination and biopsy is done forcarcinomas of larynx,oropharynx and hypopharynx

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CT SCAN SHOWING LEFT

GLOTTIC CARCINOMA

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Cross Sectional Picture Showing

The Paranasal Sinuses

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MRI of paranasal sinuses showing

Carcinoma of ethmoids extending into

brain

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Direct Laryngoscopy for evaluation and biopsy

of laryngeal Carcinomas

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Endoscopic Examination of the

nasal cavity and nasopharynx

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TREATMENT OPTIONS &

MANAGEMENT Radiotherapy

Chemotherapy

Surgery

Supportive care for advanced stage carcinomas Pain Relief

Feeding

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SURGICAL TECHNIQUES

Block Dissection (if cervical nodes are

positive)

Wedge resection (for early lesions)

Marginal or segmental mandibular

resection

Radical parotidectomy

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RECONSTRUCTION

Tumor resection in the head and neck

produces cosmetic and functional

defects that needs prosthetic orreconstructive surgery.

Options For Reconstruction

Local Flaps

Distant Flaps

Free Flaps

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TUMOR OF THE LIP

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EXCISION OF THE TUMOR

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Reconstruction With Local

Flap

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Patient 3 Months after surgery

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CONCLUSION

Carcinomas of the head & neck region

pose a significant challenge as regards

to early diagnosis , treatment andreconstruction. A multidisciplinary

approach is adapted to deal with these

tumors.

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THANKY

OU