Oropharyngeal tumors



Oropharyngeal tumors are becoming more common today. In men, these tumors occur up to 7 times more often than in women. Risk factors include high-risk HPV infections, smoking and alcohol. The average age is between 50-60 years. Currently, mainly HPV + lesions occur in younger patients.

Tumor types
Primary


 * Benign tumors are rare (in children - hemangiomas, lymphangiomas , which may narrow the airways, hemangiomas may bleed).
 * Malignant tumors
 * The vast majority are differentiated squamous cell carcinomas.
 * Adenocarcinoma is less common.
 * Lymphomas ( Waldeyer 's circuit ,…), more rarely malignant melanoma, sarcoma appear among mesenchymal tumors.

Secondary


 * Propagation of tumors from the environment (mainly from the gl. Parotis).

Symptoms
In the beginning, tumors do not have a specific symptomatology. The first symptom is usually sign of inflammation in specific area (unlike inflammation, the problems are often one-sided):


 * scratching in the throat, pain, foreign body sensation, dysphagia, blood in the saliva, rhinolalia.

The first symptoms are often overlooked (due to the most commonly affected social group).


 * Over time, the symptoms become more pronounced and the pain may shoot into the ear.
 * Exulceration → foetor ex ore.
 * Sometimes regional metastases may be the first symptom.

Diagnostics

 * Palpation is of great importance.
 * We take a biopsy, indicated panendoscopy to verify the scope of the process.

Clinical picture

 * Tumor macroscopy :
 * only as a thickening of the mucosa;
 * as an exophyte of various shapes;
 * have the form of an ulcer - it can grow into tonsils, the root of the tongue, the storey arch.


 * Patients usually arrive at a late stage - at a time when the tumor has exceeded 4 cm.
 * 40% already have metastases in the trigonum caroticum.
 * The 3 most common locations are the tonsils, the root of the tongue and the posterior wall of the pharynx (hereinafter eg floor arches).


 * Forms:
 * The most common passes from the almond to the root of the tongue, to the trigonum retromolare.
 * The second most common form comes from the root of the tongue and spreads along the edge of the tongue.
 * Spread caudally is rare.


 * Cryptogenic tumor


 * A small tumor of the tonsils or root of the tongue, which is not detectable by examination methods.

Treatment
Surgery, radiotherapy and their combinations are used in the treatment of oropharyngeal tumors.

Source

 * BENEŠ, Jiří. Study materials  [online]. © 2007. [feeling. 14. 12. 2011]. < http://jirben2.chytrak.cz/materialy/orl_jb.doc >.