- Risk Factors
- Tobacco + Alcohol: Synergistic effect (multiplicative risk).
- HPV-16: #1 cause of Oropharyngeal SCC. Younger pts, better prognosis.
- Field Cancerization: Diffuse mucosal damage → high risk of second primary tumor.
- Key Lesions
- Leukoplakia: White plaque, cannot be scraped. Biopsy to r/o cancer (low risk).
- Erythroplakia: Red plaque. High risk of malignancy. Biopsy mandatory.
- Diff Dx: Oral Hairy Leukoplakia (EBV in HIV, lateral tongue, benign).
- Nasopharyngeal Carcinoma (NPC)
- Associations: EBV, Asian ancestry (China), nitrosamines (salted fish).
- Presentation: Neck mass + Unilateral Serous Otitis Media (adult).
- Pathology & Tx
- Histology: Squamous Cell Carcinoma (SCC, >90% of head and neck cancers t ) → Keratin pearls, intercellular bridges.
- Tx: Surgery/Radiation. Cetuximab (anti-EGFR) for advanced disease.