Aim
Learning Objectives:
Understand the anatomy of the oropharynx and its relationship to surrounding structures
Assess the Lymph nodal stations/levels and drainage patterns in oropharyngeal primaries
Identify subsites of the oropharynx and common locations of primary SCC
Common patterns of spread of primary tumors and how they influence the TNM staging
Introduction:
Oropharynx is the part of the pharynx which liesbetween the soft palate and the upper edge of the epiglottis at the level of the hyoid bone.
(Fig. 1) It contains extensive lymphatic drainage and...
Methods and materials
Imaging Modalities
CT and MRI are the modalities of choice in assessing the morphology of the primary lesions and their association with adjacent structures.
Nodal involvement can also be evaluated particularly with the use of MRI.
PET imaging are also used frequently to depict nodal status and distant metastasis,
therefore has a crucial role in treatment planning when used in conjunction with other modalities.
SCC is the most common histopathological type of malignancy affecting the oropharynx and it can spread in three possible ways: 1....
Results
Primary Sites of Oropharyngeal Tumors[1,
7]
1) Base of Tongue (BOT)
(Fig. 8,Fig. 9,Fig. 10,Fig. 11,Fig. 12,Fig. 13,Fig. 14)
Tumours of the BOT are insidious,
often clinically occult and therefore present in advanced stages.
Unilateral involvement of the BOT is common,
crossing the midline only when the tumour becomes too large.
MRI is the modality of choice in assessing the extent of the lesion.
Axial images are superior in assessing the size,
midline spread and the involvement of the soft palate and tonsillar region.
Coronal...
Conclusion
Oropharyngeal cancers are on the rise and understanding the anatomy and the patterns of tumor spread is valuable and imaging forms an integral component of multi-disciplinary mangement of the tumors.
As SCC of the oropharynx displays unique characteristic on CT and MRI,
multimodalty imaging provides accurate information on local spread,
neurovascular invasion and most importantly nodal involvement which in turn influences patients' TNM staging and treatment plan.
Personal information
Corresponding Author
Dr.Sandeep Bhuta MBBS,DMRD,DNB,FRANZCR
Associate Professor & Neuroradiologist
Dept.of Medical Imaging,1 Hospital Boulevard,
Griffith University,School of Medicine
Gold Coast University Hospital,
Gold Coast,
QLD,4215
Australia
Email:
[email protected]
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