Onco Surgery Head and Neck

Q1) Most common malignant tumor of parotid gland is

a) Acinar cell ca

b) Muco epidermoid

c) Adenocystic

d) Pleomorphic adenoma


Q2)  Indication of adjuvant chemo- radiotherapy in oral cavity cancer are all except

a) positive multiple lymph nodes

b) Perineural invasion

c) lympho vascular invasion

d) Extra capsular invasion
Answer2


Q3)  Feature on USG has the highest sensitivity to predict thyroid carcinoma consistently across studies?
a)Microcalcifications
b)More tall than wide
c)Solid hypoechoic nodule
d)Intranodular vascularity
Answer3


1)b

Acinar cell are low grade malignant tumors

Among primary malignant tumors, mucoepidermoid tumor is commonest followed by  adenocystic carcinoma.

Bailey page 788



2) d

Primary surgery is the traditional approach for oral cancer.

General indications for PORT include:

a) T3 or T4 tumor; compromised surgical resection margins (<5 mm from the inked surface of the specimen);

b) presence of lympho-vascular invasion (LVI)

c) peri-neural invasion (PNI); and positive lymph nodes

d )with or without extracapsular invasion (ECE)

The definition of ‘close’ resection margins is generally accepted as tumor within 5 mm of the inked resection margin in formalin fixed surgical specimens

Ref 



3) c 

High suspicion on USG 

Solid hypoechoic nodule or solid hypoechoic component of a partially cystic nodule with one or more of the following features: irregular margins (infiltrative, microlobulated), microcalcifications, taller than wide shape, rim calcifications with small extrusive soft tissue component, evidence of extrathyroidal extension

Intermediate suspicion
Hypoechoic solid nodule with smooth margins without microcalcifications, extrathyroidal extension, or taller than wide shape

Low suspicion

Isoechoic or hyperechoic solid nodule or partially cystic nodule with eccentric solid areas without microcalcification, irregular margin or extrathyroidal extension, or taller than wide shape

Ref Sabiston page 896