Head and Neck onco Q 21-30

Head and Neck Onco Questions Q 21-30

Onco Head  NEck 1-5

H& N onco Q 6-20

Q21) Lymphoma of the head and neck - False statement is 

A. Hodgkin’s disease is common in the oropharynx.
B. Most are of the B-cell type .
C. FNAC of neck lymph nodes is now mandatory.
D. For disseminated non-Hodgkin’s lymphoma, systemic chemotherapy is preferred.

Ans 21 a

Hodgkin is rare in oropharynx but NHL can be seen in 15-20%

B cells is the most common lymphoma in H& N

C is true

RAdiotherapy for localised disease and chemotherapy is for systemic disease

Q22) In buccal mucosa cancer after surgery and CRT, after 2 year patient developed cancer at base of tongue with N3 nodes positive. Best line of management
A .Palliative RT
c. Rehabilitation
D.  Surgery followed CTRT

There are two parts to this questions 

a) Second Primary tumor (SPM)

b) Management of Base of tongue tumors with N3

Both are discussed here ---

Ans22 b) 

Second Primary Tumor (SPM) 

A synchronous SPM is diagnosed simultaneously or within six months of the index tumor, while a metachronous SPM is diagnosed greater than six months after the index tumor. SPMs need to be distinguished from local recurrences or metastasis of the primary tumor.

Warren and Gates criteria for second primary malignancy 

Histologic confirmation of malignancy in both the index and secondary tumors.

The two malignancies must be anatomically separated by normal mucosa.

The possibility of the SPM being a metastasis from the index tumor must be excluded.

In general, the SPM is treated in a similar fashion as a primary index tumor at the subsite of origin.

Base of tongue tumors

Oropharyngeal squamous cell carcinomas arise in the soft palate, tonsils, base of tongue, pharyngeal wall, and vallecula, the fold located between the base of tongue and the epiglottis

For patients with potentially resectable disease, nonsurgical functional organ-preservation approaches that include both chemotherapy and radiation therapy (RT) are generally used, even when gross removal of the entire tumor with acceptable functional and cosmetic outcomes is thought to be feasible.