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www.entnet.orgChapter 16
Head and Neck Cancer
Diagnosis and management of head and neck cancer is a broad topic. In this
chapter we will provide background information about the disease, informa-
tion on diagnosis and management, and a few case studies. These will help
you understand how to integrate information and treatment modalities to
affect a successful, modern approach to head and neck cancer.
Head and neck cancer primarily refers to carcinomas of the larynx; naso-,
oro-, and hypopharynges; paranasal sinuses; salivary glands; and oral cav-
ity. Historically, the majority of these cancers occurred in patients with a
history of smoking and alcohol use, and were squamous cell carcinomas of
the upper aerodigestive tract. While this is still true, the incidence of
oropharyngeal cancers is increasing, primarily due to HPV-mediated can-
cers.
Almost all (95%) head and neck cancer is squamous cell carcinoma. The
cancer originates from the
cuboidal cells
along the basement membrane
of the mucosa. Under the microscope, the
cancerous cells appear flat, so the cancer is
called squamous (from the Latin
squama
,
“a scale or platelike structure”) cell carci-
noma.
Figure 16.1 is a common presentation of a
head and neck cancer. An adult patient
with a persistent lump in the neck is very
likely to have a malignant process, with its
origins in the upper aerodigestive tract. A
single course of antibiotics is warranted,
but preparation should be made for imme-
diate consultation with an otolaryngolo-
gist–head and neck surgeon, as there is a
high likelihood that this represents a neo-
plasm.
Figure 16.1.
Neck mass in an adult patient with
squamous cell carcinoma of the hypo-
pharynx who presented to the primary care
physician with a large, firm neck mass.
Needle aspiration confirmed the diagnosis
of squamous cell carcinoma.