2 Head and neck tumorsTumors 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
3 Risk Smoking and chewing tobacco. Heavy alcohol use. A diet low in fruits and vegetables.Chewing betel quid, a stimulant commonly used in parts of Asia.Being infected with human papilloma virus (HPV).EBV infection.plummer-Vinson syndrome.poor nutritionill-fitting dentures and other rough surfaces on the teethP53 mutation
4 RiskAlcohol and tobacco use are the most common risk factors. They are likely synergistic in causing cancerpoor diet resulting in vitamin deficienciesEnvironmental carcinogens include occupational exposures such as nickelBUT- 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 Dietary factorsExcessive consumption of processed meats and red meat were associated with increased rates of cancerBetel nut chewing is associated with an increased risk of squamous cell cancer of the head and neckSalted fish (nitrites) – nasopharyngeal carcinomaConsumption of raw and cooked vegetables seemed to be protective.Vitamin E was not found to prevent the development of leukoplakia
6 Human papillomavirusHPV16, 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 Associated with nasopharyngeal cancer – high grade. Nasopharyngeal cancer occurs endemically - Mediterranean countries and Asia, EBV antibody titers can be measured to screen high-risk populations
8 Oral cavity – benign epithelial tumors Squamous papillomaless common than in larynxAdults yrsHPV 6 and 11Condyloma accuminatumyoung adults – lip, palateVerruciform xantomaMiddle aged toolder adultsAlveolar ridges
9 Prognosis HPV-positive cancers tend to have higher survival rates. The prognosis for people with oropharyngeal cancer depends on the age and health of the person and the stage of the disease. It is important for people with oropharyngeal cancer to have follow-up exams for the rest of their lives as cancer can occur in nearby areas.It is important to eliminate risk factors such as smoking and drinking alcohol, which increase the risk for second cancersLocation and type of tumor
19 ErythroplakiaErythroplakia 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.
33 Oral cavity, neuroectodermal tu NeurinomaNeurofibromaMelanocytic nevusMalignant melanoma60 yrs (20-80)More aggresive than cutaneous
34 Odontogenic tumor Rare, from remnants od dental crest Classification: EpithelialMesenchymalMixed
35 Epithelial odontogenic tumors Ameloblastoma (adamantinoma)Calcifying epithelial odontogenic tumor(Pindborg´s tumor), slowly growing, painless, posterior mandibleAdenomatoid odontogenic tumorAnterior portion of maxila, younger than 30, females,Squamous odontogenic tumorMalignant ameloblastoma and ameloblastic carcinoma(1% of ameloblastomas)
36 Ameloblastoma (Adamantinoma) The most commonManifestation yrsMandibulaCystic, ill.defined borders – destructive growts,histology: Histopathology will show cells that have the tendency to move the nucleus away from the basement membrane. This process is referred to as "Reverse Polarization". The follicular type will have outer arrangement of columnar or palisaded ameloblast like cells and inner zone of triangular shaped cells resembling stellate reticulumCommom reccurencesMay be malignant transformation
49 Mesenchymal odontogenic tumors Odontogenic fibroma55% in mandible 45% in maxilla2/3 of maxillary tumors found in the anterior segment4-80 yearsFemales 69%Recurrence rate is lowCellular tumor with minimal ground substance and droplets of calcified matrix representing bone or atubular dentinSmall round nests and irregular clusters of epithelial cells
52 Mixed odontogenic tumors Ameloblastic fibromaChildhood, adolescenceAmeloblastic fibromas are neoplasms of odontogenic epithelium and mesenchymal tissues2% of odontogenic tumorsUni or multilocular cysts
55 Mixed odontogenic tumors Odontoma66% of odontogenic tumors are odontomashamartomaBetween 10. and 20 yearsMore often in maxilacompound odontoma - three separate dental tissues (enamel, dentin and cementum) no definitive demarcation of separate tissues between the individual "toothletsComplex odontoma - type is unrecognizable as dental tissues, usually presenting as a radioopaque area with varying densities.
63 Salivary gland tumorSalivary gland neoplasms make up 6% of all head and neck tumorsSalivary gland neoplasms most commonly appear in the sixth decade of life. Patients with malignant lesions typically present after age 60 years, whereas those with benign lesions usually present when older than 40 years. Benign neoplasms occur more frequently in women than in men, but malignant tumors are distributed equally between the sexes.80% arise in the parotid glands, 10-15% arise in the submandibular glands, and the remainder arise in the sublingual and minor salivary glands. Almost 50% submandibular gland neoplasms and most sublingual and minor salivary gland tumors are malignant.
64 Most patients with salivary gland neoplasms present with a slowly enlarging painless mass. Laryngeal salivary gland neoplasms may produce airway obstruction, dysphagia, or hoarseness.Minor salivary tumors of the nasal cavity or paranasal sinus can manifest with nasal obstruction or sinusitis. Facial paralysis or other neurologic deficit associated with a salivary gland mass indicates malignancy.Pain may be a feature associated with both benign and malignant tumors. Pain may arise from suppuration or hemorrhage into a mass or from infiltration of a malignancy into adjacent tissue.
70 Salivary gland neoplasms are rare in children Salivary gland neoplasms are rare in children. Most tumors (65%) are benign, with hemangiomas being the most common, followed by pleomorphic adenomas.35% of salivary gland neoplasms are malignant. Mucoepidermoid carcinoma is the most common salivary gland malignancy in children.
71 Pleomorphic adenomacommon benign salivary gland neoplasm characterised by neoplastic proliferation of parenchymatous glandular cells along with myoepithelial components, having a malignant potentiality.It is the most common type of salivary gland tumor and the most common tumor of the parotid gland.It derives its name from the architectural pleomorphism (variable appearance) seen by light microscopy. It is also known as "Mixed tumor, which describes its pleomorphic appearance as opposed to its dual origin from epithelial and myoepithelial elements
74 Warthin's tumor the second most common benign parotid tumor. strong association with cigarette smoking. Smokers are at 8 times greater risk of developing Warthin's tumor than the general populationWarthin's tumor primarily affects older individuals (age 60–70 years). There is a slight female predilection according to recent studies, but historically it has been associated with a strong male predilection.