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Head and Neck Cancer

What do focal calcifications mean?

08/31/2007

Question:

I have concern about CT scan of neck report. Are they symptomatic of a malignancy? I have a right sided asymmetry associated with growth on base of tongue. Most likely a cyst of some sort, but it has these calcifications and they extend to hyoid bone. Four borderline lymph nodes. Mostly level II. one level III. One measured larger on ultrasound was labled as abnormal than on CT scan, which is most accurate? Dr asked if I wanted to excise the nodes as well as biopsy the growth? What do you recommend?

Answer:

CT scanning with contrast is considered by many to be the gold standard to evaluate for masses and nodes in the head and neck region. The results of this scan although worrisome need to be interpreted considering your symptoms and physical findings. If, with all the information available, your physician is worried that there is definitely something in the back of your tongue, this may explain the presence of enlarged lymph nodes in your neck. If this is the case, then something should be done.

It is customary to examine the patient in the operating room under anesthesia and to perform a biopsy of the suspected site, in your case the base of the tongue. In the event that nothing is found in your throat it may then be appropriate to biopsy the neck nodes. It often can be done in the office with a fine needle. Occasionally, as a last resort, the neck may be open to obtain an adequate biopsy. Your physician should be able to explain that to you in detail and lead you every step of the way.

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Response by:

Cheryl  Koliha-Brandt, MSN, RN, CNS, CORLN Cheryl Koliha-Brandt, MSN, RN, CNS, CORLN
Clinical Nurse Specialist and Instructor of
Head and Neck Surgery and Oncology 
Frances Payne Bolton School of Nursing
Case Western Reserve University

Pierre  Lavertu, MD, FRCS(C), FACS Pierre Lavertu, MD, FRCS(C), FACS
Professor of Otolaryngology-Head and Neck Surgery
School of Medicine
Case Western Reserve University