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Head and neck tumors

Head and neck tumors. Head and neck tumors. Tumors of the nasal cavity , paranasal sinuses , oral cavity , nasopharynx , oropharynx , salivary glands , hypopharynx , and larynx. Also tumors of local lymphoid tissue , skin, ear , eye , thyroid gland. Risk.

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Head and neck tumors

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  1. Headandnecktumors

  2. Headandnecktumors Tumorsofthenasalcavity, paranasalsinuses, oral cavity, nasopharynx, oropharynx, salivaryglands, hypopharynx, and larynx. Alsotumorsoflocallymphoidtissue, skin, ear, eye, thyroidgland

  3. Risk • Smoking andchewingtobacco. • Heavyalcohol use. • A diet low in fruitsandvegetables. • Chewing betel quid, a stimulant commonlyused in partsofAsia. • Beinginfectedwithhumanpapilloma virus (HPV). • EBV infection. • plummer-Vinson syndrome. • poornutrition • ill-fittingdenturesandotherroughsurfaces on theteeth • P53 mutation

  4. Risk • Alcohol and tobacco use are the most common risk factors. Theyare likely synergistic in causing cancer poor diet resulting in vitamin deficiencies • Environmental carcinogens include occupational exposures such as nickel • BUT-marijuana use was not shown to be associated with oral squamous cell carcinoma (potential protective factor against the development of head and neck squamous cell carcinoma

  5. Dietaryfactors • Excessive consumption of processed meats and red meat were associated with increased rates of cancer • Betel nut chewing is associated with an increased risk of squamous cell cancer of the head and neck • Salted fish (nitrites) – nasopharyngealcarcinoma • Consumption of raw and cooked vegetables seemed to be protective. • Vitamin E was not found to prevent the development of leukoplakia

  6. Human papillomavirus • HPV16, is a causal factor for some head and neck squamous cell carcinoma . Approximately 15 to 25% contain genomic DNA from HPV, • HPV-positive oropharyngeal cancer, with highest distribution in the tonsils, where HPV DNA is found in (45 to 67%) of the cases, • less often in the hypopharynx (13%–25%) • least often in the oral cavity (12%–18%) and larynx (3%–7%). • cancers of the tonsil may be infected with HPV(25%) • Oral sex can result in HPV-related cancer

  7. Epstein-Barr virus • Associatedwithnasopharyngealcancer – high grade. • Nasopharyngealcanceroccursendemically - MediterraneancountriesandAsia, EBV antibodytiterscanbemeasured to screenhigh-risk populations

  8. Oral cavity – benignepithelialtumors • Squamouspapilloma • lesscommonthan in larynx • Adults 30-50 yrs • HPV 6 and 11 • Condylomaaccuminatum • youngadults – lip, palate • Verruciformxantoma • Middleagedtoolderadults • Alveolarridges

  9. Prognosis • HPV-positive cancerstend to havehighersurvivalrates. • Theprognosisforpeoplewithoropharyngealcancerdepends on theageandhealthofthe person andthestageofthedisease. Itisimportantforpeoplewithoropharyngealcancer to havefollow-upexamsforthe rest oftheirlives as cancercanoccur in nearbyareas. • Itisimportant to eliminate risk factors such as smoking anddrinkingalcohol, whichincreasethe risk forsecondcancers • Locationand type of tumor

  10. Oral cavity –precursor (premalignantlesions) • HIGH-risk lesions • Leukoplakia • Erythroplakia • speckledErythroplakia (a mixtureofboth) • chronichyperplasticcandidiasis • dysplasia • Medium- risk lesions • oral submucosalfibrosis • syphiliticglossitis • sideropenicdysphagia • low-risk lesions • oral lichenplanus • discoid lupus erythematosus • discoidkeratosiscongenita

  11. Precanceroses

  12. Leukoplakia

  13. Leukoplakia

  14. Leukoplakia

  15. High grade dysplasia

  16. Erythroplakia Erythroplakia is a general term for red, flat, or eroded velvety lesions that develop in the mouth. In this image, an exophytic squamous cell carcinoma is surrounded by a margin of erythroplakia.

  17. Erythroplakia

  18. Oral cavity – malignantepithelialtumors • Squamous cell carcinoma (thevast majority ofheadandneckcancers) • Conventional (keratinizing) • Endophytic X exophytic X ulcerated • Nonkeratinizing • HPV16-95% • Asymptomaticneckmass • Verrucouscarcinoma • Welldifferentiated, non metastasizing ca • Spindle cell ca • Adenosquamouscarcinoma • Neuroendocrice ca • High grade, poorprognosis

  19. Oral cavity – malignantepithelialtumors • Squamouscarcinomas – the most common • Prognosisassociatedwithlocation • Lip (goodprognosis) • Tongue (highlyaggresive) • Mouthfloor (highlyaggresive) • Bucalmucosa (highlyaggresive) • Gingiva (slowgrowth)

  20. Squamous cell carcinoma

  21. Squamous cell carcinoma

  22. Squamous cell carcinoma

  23. Verrucouscarcinoma

  24. Oral cavity, mesenchymal tu • Vascular • Pyegenicgranuloma (Lobularcapillaryhemangioma), lip, tongue, gingivalandbucalmucosa • Hemangioma • Lymphangioma • Kaposi´s sarcoma

  25. Oral cavity, mesenchymal tu • Peripheralossifying tumor • Gingiva, alongincisors • Peripheralgiant cell granuloma • Gingiva alongincisors, caused by chronicirritation • Congenitalgranular cell epulis • Lipoma • Osteoma(torus palatinus, mandibularis)‏ • Fibrosarcoma

  26. Fibroepithelial polyp

  27. Fibroepithelial polyp

  28. Oral cavity, neuroectodermal tu • Neurinoma • Neurofibroma • Melanocyticnevus • Malignantmelanoma • 60 yrs (20-80) • More aggresivethancutaneous

  29. Odontogenic tumor Rare, fromremnants od dentalcrest Classification: Epithelial Mesenchymal Mixed

  30. Epithelialodontogenictumors Ameloblastoma(adamantinoma)‏ Calcifyingepithelialodontogenictumor (Pindborg´s tumor)‏, slowlygrowing, painless, posteriormandible Adenomatoidodontogenictumor Anteriorportionof maxila, youngerthan 30, females, Squamousodontogenictumor Malignantameloblastomaandameloblasticcarcinoma (1% ofameloblastomas)

  31. Ameloblastoma (Adamantinoma) Themost common Manifestation20.-40 yrs Mandibula Cystic, ill.definedborders – destructivegrowts, histology: Histopathologywill show cellsthathavethetendency to movethenucleusawayfromthebasementmembrane. Thisprocessisreferred to as "Reverse Polarization". Thefollicular type willhaveouter arrangement ofcolumnarorpalisadedameloblastlikecellsandinnerzoneoftriangularshapedcellsresemblingstellatereticulum Commomreccurences May bemalignanttransformation

  32. Ameloblastoma (adamantinoma)

  33. Ameloblastoma

  34. Ameloblastoma

  35. Calcifyingepithelialodontogenic tumor

  36. Mezenchymalodontogenictumors Cementoblastoma Cemento-ossifyingfibromafibrom Odontogenicfibroma Odontogenicmyxoma

  37. Mesenchymal odontogenic tumors Cementoblastoma Childhood Both jaws Cementoblastic proliferation around molars

  38. Cementoblastoma

  39. Cementoblastoma

  40. Mesenchymal odontogenic tumors Odontogenicmyxoma arisingfromembryonicconnectivetissueassociatedwithtoothformation. consistsmainlyofspindleshapedcellsandscatteredcollagenfibersdistributedthrough a loose, mucoidmaterial. youngpeople ill- definedborders bone resorption Localinfiltration highrecurrencerate

  41. Mesenchymal odontogenic tumors Odontogenic myxoma

  42. MezenchymalodontogenictumorsOdontogenicmyxoma

  43. Mesenchymal odontogenic tumors Odontogenic fibroma 55% in mandible45% in maxilla 2/3 of maxillary tumors found in the anterior segment 4-80 years Females 69% Recurrence rate is low Cellular tumor with minimal ground substance and droplets of calcified matrix representing bone or atubular dentin Small round nests and irregular clusters of epithelial cells

  44. MesenchymalodontogenictumorsOdontogenicfibroma

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