The stage of squamous neck cancer depends on the primary tumor. The cancer may be metastatic (really far away from the original organ) or locoregional (reaching lymph nodes in the neck). In some cases, the primary tumor is not recognizable by a physical exam. Therefore, there is no standard staging system for metastatic squamous neck cancer. Instead, it is classified based on the signs and symptoms of the disease.
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Head and neck squamous cell carcinoma (HNSCC) is derived from the stratified epithelium of the upper aerodigestive mucosa. It is distinguished from other forms of cancer primarily by its squamous differentiation. A well-differentiated tumour resembles stratified epithelium, with mature-appearing cells arranged in layers and irregular keratinization. This morphology is most easily recognized in a keratin pearl tumour. A poorly-differentiated tumour, on the other hand, contains immature cells, a lack of stratification and minimal stratification.
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Metastatic squamous neck cancer is treated within a clinical trial. Treatment for occult primary squamous neck cancer may not be as effective as chemotherapy, however, some treatments are available. Treatments for metastatic squamous neck cancer should be tailored to the specific patient's needs and symptoms. Although many patients with metastatic squamous neck cancer may be eligible for clinical trials, the treatment options will depend on the specific type of cancer and its stage.
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Patients with suspected squamous neck cancer may undergo a PET-CT scan. In patients with unclear primary head and neck squamous cell cancer, PET-CT scans have a 68.9% negative predictive value. In this study, 32 patients whose PET-CT scans did not detect the primary tumor had the cancer on direct laryngoscopy. Of these, five6% had tonsillar cancer while twenty-five percent of the patients had tumors in the nasopharynx and hypopharynx. Multiple authors support the use of PET-CT scans for NCUP prior to direct laryngoscopy.
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Depending on the type of cancer, radiation therapy can be a viable treatment option. During the procedure, doctors remove lymph nodes from one side of the neck and may also remove certain muscles. Sometimes, they may also remove the jugular vein. If surgery is not sufficient, radiation therapy is used to kill cancer cells that are left behind. This lowers the chance of the cancer coming back. External radiation therapy is a treatment option for squamous neck cancer.
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Patients with solid neck masses that harbor squamous cell carcinoma will have an 80% positive result. Repeat FNA can yield additional increment if the solid neck mass is detected. Generally, repeat examinations are necessary to confirm the diagnosis. In rare cases, a biopsy of the neck can show other symptoms that indicate a malignancy. For instance, a neck mass with multiple nodules or lymph nodes may be benign.
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Squamous neck cancer is an aggressive type of cancer and requires aggressive treatment. Symptoms include swelling under the chin and pain in the chin and neck. A physician may recommend biopsy or further tests. However, if the biopsy shows that cancer cells are present, the cancer may be treatable in the neck. When it is detected early, treatment options will be more effective. The disease may have spread elsewhere, but the treatment of squamous cell cancer will depend on its primary site.
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Treatment for SCC can include topical medications such as imiquimod. Treatment can also involve surgical removal of a portion of the tumor. After the tumor is removed, patients should monitor their skin for precancerous areas monthly. Additionally, patients should avoid the sun during the hottest part of the day, between 10 a.m. and 5 p.m. During the treatment, patients should avoid exposure to UV rays.
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Surgical treatment of squamous cell cancer in the neck involves removal of a portion of the tumor and some surrounding tissues. The sample is examined under a microscope to confirm the presence of cancer cells. If a biopsy finds cancer cells, a patient may be treated with systemic treatment combining chemotherapy and radiation. This requires a multidisciplinary team approach to care. Immunotherapy blocking PD-1 receptor has shown promising results in patients with advanced squamous cell cancer. Clinical trials of this therapy are currently underway.
