Head and neck carcinomas

Last updated: May 5, 2022

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Head and neck carcinomas arise in the squamous cells of the mucosal epithelium in the nasal cavity, paranasal sinuses, oral cavity, pharynx, larynx, and trachea. Other nonsquamous cell carcinomas arise in salivary glands, sinuses, muscles, and nerves of the head and neck. Excluding nonmelanoma skin cancer, oral cavity malignancy is the most common head and neck carcinoma. Nasal cavity, oral cavity, and larynx cancers are generally associated with tobacco and/or alcohol use, whereas pharyngeal carcinomas are typically caused by infections with human papillomavirus and Epstein-Barr virus. Clinical features depend on the site and etiology of the primary tumor. Treatment usually involves surgery followed by radiotherapy and/or chemotherapy. Cancers of the brain, eye, ears, esophagus, thyroid gland, and skin of the head and neck are generally not classified as head and neck cancers and are discussed in other articles.

Oral cavity carcinoma, pharyngeal carcinoma, and laryngeal carcinoma are discussed in more detail in their respective articles.

Overview of nasal cavity, paranasal sinus, and pharyngeal cancers
Type Nasal cavity carcinoma Paranasal sinus carcinoma Pharyngeal carcinoma [2]
Nasopharyngeal carcinoma [3] Hypopharyngeal carcinoma Oropharyngeal carcinoma [4]
Epidemiology
Risk factors and associations
  • Tobacco use
  • Chronic and/or occupational inhalation exposure to wood dust
  • HPV infection
  • Tobacco and/or alcohol use
  • Betel nut chewing
  • Exposure to radiation
  • Inhalation exposure to glues and adhesives
Clinical features
Diagnostics
Treatment

Overview of oral cavity, tonsil, tongue, salivary glands, and lip cancers [3]
Type Oral cavity carcinoma [2][4] Tonsil carcinoma Tongue carcinoma [6] Salivary gland carcinoma Lip carcinoma [7][8]
Epidemiology
Risk factors and associations
  • Oral tobacco use and smoking
  • Long-term alcohol use
  • Human papillomavirus, particularly HPV 16, 18, 31, and 33
  • Stem cell transplants
  • Poor oral hygiene, chronic mechanical irritation (e.g., incorrectly positioned dentures)
  • Precancerous lesions (e.g., leukoplakia, erythroplakia)
Clinical features
Diagnostics
Treatment

Overview of laryngeal and tracheal cancers [6]
Type Laryngeal carcinoma [2][12] Tracheal carcinoma [13]
Supraglottic carcinoma Glottic carcinoma Subglottic carcinoma
Epidemiology
Risk factors and associations
  • Tobacco and/or alcohol use
  • HPV 6 and 11
  • Exposure to paint, asbestos, gasoline fumes, and radiation
  • Betel nut chewing
  • Diets rich in nitrosamines and fats
  • Tobacco use
  • Exposure to hydrocarbons (e.g., wood smoke, asphalt fumes)
Clinical features
  • Usually discovered at an advanced stage
  • Dysphagia
  • Hoarseness (usually late-onset)
  • Foreign body sensation
  • Airway obstruction
Diagnostics
Treatment

Definition

Tumors arising in the nasal cavity and/or paranasal sinuses.

Epidemiology [5]

Etiology [14]

Clinical features

Diagnostics

Treatment

Complications

Prognosis [15]

The five-year relative survival rate for nasal cavity and paranasal sinus carcinomas is ∼ 80%.

A patient with unilateral difficulty breathing through the nose may have a malignant tumor.

Definition

A malignant tumor of the lips.

Epidemiology

Etiology [16]

Histological subtype [16]

Clinical features

  • Infiltrative or exophytic lesion of the lips
  • Ulcer lesion
  • Pain, numbness, and/or bleeding of the lip
  • Advanced stage: loss of sensation around the chin and/or invasion of the premaxilla and nasal cavity

Diagnostics

Treatment [16]

Prognosis [8][17]

Definition

A malignant tumor of the trachea.

Classification

Epidemiology [18]

Etiology

Clinical features [13]

Diagnostics

Treatment [19]

Prognosis

The five-year overall survival rate for ACC is approx. 80% and approx. 10% for SCC. [13]

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  2. Chang ET, Ye W, Zeng Y-X, Adami H-O. The Evolving Epidemiology of Nasopharyngeal Carcinoma. Cancer Epidemiology Biomarkers & Prevention. 2021; 30 (6): p.1035-1047. doi: 10.1158/1055-9965.epi-20-1702 . | Open in Read by QxMD
  3. Weatherspoon DJ, Chattopadhyay A, Boroumand S, Garcia I. Oral cavity and oropharyngeal cancer incidence trends and disparities in the United States: 2000–2010. Cancer Epidemiology. 2015; 39 (4): p.497-504. doi: 10.1016/j.canep.2015.04.007 . | Open in Read by QxMD
  4. Turner JH, Reh DD. Incidence and survival in patients with sinonasal cancer: a historical analysis of population-based data.. Head Neck. 2012; 34 (6): p.877-85. doi: 10.1002/hed.21830 . | Open in Read by QxMD
  5. Gunderson LL. Clinical Radiation Oncology. Elsevier Health Sciences ; 2015
  6. Regezi JA, Sciubba JJ, Jordan RCK. Oral Pathology. Saunders ; 2012
  7. Han AY, Kuan EC, Mallen-St Clair J, Alonso JE, Arshi A, St John MA. Epidemiology of Squamous Cell Carcinoma of the Lip in the United States. JAMA Otolaryngology–Head & Neck Surgery. 2016; 142 (12): p.1216. doi: 10.1001/jamaoto.2016.3455 . | Open in Read by QxMD
  8. What Are the Key Statistics About Oral Cavity and Oropharyngeal Cancers?. https://www.cancer.org/cancer/oral-cavity-and-oropharyngeal-cancer/about/key-statistics.html. Updated: January 6, 2017. Accessed: February 16, 2017.
  9. Marchese-Ragona R, De Filippis C, Marioni G, Staffieri A. Treatment of complications of parotid gland surgery. Acta Otorhinolaryngol Ital. 2005; 25 (3): p.174-178.
  10. Brunicardi F, Andersen D, Billiar T, et al.. Schwartz's Principles of Surgery. McGraw-Hill Education ; 2014
  11. Laryngeal and Hypopharyngeal Cancers. https://www.cancer.org/cancer/laryngeal-and-hypopharyngeal-cancer/about/key-statistics.html. Updated: January 12, 2022. Accessed: February 8, 2022.
  12. Napieralska A, Miszczyk L, Blamek S. Tracheal cancer – treatment results, prognostic factors and incidence of other neoplasms. Radiology and Oncology. 2016; 50 (4): p.409-417. doi: 10.1515/raon-2016-0046 . | Open in Read by QxMD
  13. Gaissert HA, Mark EJ. Tracheobronchial Gland Tumors. Cancer Control. 2006; 13 (4): p.286-294. doi: 10.1177/107327480601300406 . | Open in Read by QxMD
  14. Sherani K, Vakil A, Dodhia C, Fein A. Malignant tracheal tumors. Curr Opin Pulm Med. 2015; 21 (4): p.322-326. doi: 10.1097/mcp.0000000000000181 . | Open in Read by QxMD
  15. Wenig BM. Atlas of Head and Neck Pathology. Elsevier Health Sciences ; 2015
  16. Survival Rates for Nasal Cavity and Paranasal Sinus Cancers. https://www.cancer.org/cancer/nasal-cavity-and-paranasal-sinus-cancer/detection-diagnosis-staging/survival-rates.html. Updated: April 19, 2021. Accessed: December 20, 2021.
  17. Head and neck cancers. https://www.cancer.gov/types/head-and-neck/hp/adult/lip-mouth-treatment-pdq. Updated: January 1, 2021. Accessed: November 10, 2021.
  18. Raskob GE, Zitsch RP, Park CW, Renner GJ, Rea JL. Outcome Analysis for Lip Carcinoma. Otolaryngology–Head and Neck Surgery. 1995; 113 (5): p.589-596. doi: 10.1177/019459989511300510 . | Open in Read by QxMD
  19. Head and Neck Cancer: Statistics. https://www.cancer.net/cancer-types/head-and-neck-cancer/statistics. Updated: February 1, 2021. Accessed: January 4, 2022.

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