What is a radical neck dissection? when is it done?

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What is a radical neck dissection? The surgeon removes a block of tissue from the collarbone to the jaw and from the front to the back of the neck. The large muscle on the side of the neck that is used for rotating, flexing or extending the neck is also taken out, along with the major vein on the side of the neck. Sometimes, a less drastic operation, called a supraomohyoid neck dissection is done. This takes out only the lymph nodes, the tissue surrounding the nodes and a muscle at the front of the neck. Another technique, called a functional neck dissection, saves the muscles of the neck, taking out only the lymph nodes and tissues surrounding them.
What kind of incision is made with a radical neck dissection? The incision depends upon what the surgery is for. It can run from below the ear to the collarbone. Everything in the front of the neck on one side or on both sides may be removed. This may include the lymph nodes, blood vessels, nerves, and the salivary gland under the jawbone.

What kind of cancer is sarcoma?

What are sarcomas?

Sarcomas are cancers that begin in the body's connective tissues. They are usually divided into two groups: bonecancers and soft tissue sarcomas.

Are there special physicians who treat sarcomas? 

It is best for someone diagnosed with sarcoma to begin treatment in a hospital that has an expert staff and resources to apply all forms of effective treatment from the very beginning. Surgery, chemotherapy, and radiation are often used in the initial treatment of sarcoma. It is important for specialists in these fields to decide jointly on the treatment plan.

Persons Most Likely to Get Sarcomas 

• Those persons exposed to heavy doses of radiation
• Those who have Paget's disease

Symptoms of Sarcomas 

• Persistent ache, mostly in the knees, thighs, upper arms, ribs, pelvis
• Pain, especially if worse at night
• Swelling or fever
• Repeated, unexplained stumbling
• Unexpected fracture
• Inability to move a body part normally

How are sarcomas diagnosed? 

The doctor will ask questions about symptoms and past health problems and examine the affected site. X-rays are taken of the affected area of the body. If the doctor suspects bone or soft tissue sarcoma, further tests such as chest xrays, laboratory analyses of urine and blood, tomograms,and CT scans are done. Sometimes a scintigram injecting a radioactive substance into a vein and scanning the skeleton with a special camera which shows whether there is radioactivity in the area of rapidly dividing cells is done. A biopsy is the next step. For bone cancer it consists of cutting or punching a sample of tissue from what the radiographs show is the most typical part of the suspected area.

What is bone cancer? 

Any malignant tumor developing in the skeletal system is known as bone cancer. It begins in the hard substance of the bone itself, a highly specialized connecting tissue which forms the rigid framework that bears body weight, provides fixed points for muscle action, and protects vital organs of the body. Bone cancer is relatively rare. About 1,900 new cases are diagnosed each year in the United States.

Who is at high risk for bone cancer? 

Persons who have been exposed to heavy doses of radiation, such as radium workers, are at higher risk for bone cancer and soft tissue sarcoma. In the future, the number of sarcoma cases caused by radiation is expected to be smaller due to the growing use of megavoltage radiotherapy, which spares bone and soft tissue from high doses. Paget's disease, a noncancerous disorder resulting in bone deformity, leads to bone cancer in some cases. Osteogenic sarcoma tends to arise in bones that grow very rapidly, with the peak occurrence among teenagers.

Are all bone tumors cancerous? 

No. Many tumors of the bone are not cancerous.

What are the symptoms of bone cancer? 

Pain is the most noticeable symptom in bone cancer, especially if the pain is worse at night. A persistent ache may develop anywhere in the skeleton, but most often in the knee, thigh, upper arm, ribs, and pelvis. There may be swelling or fever. There may be repeated, unexplained stumbling. In children, these symptoms are often dismissed as due to a sprain or growing pains until the size of the tumor and the amount of pain make its seriousness apparent. In older people, cancer may be discovered only when a weakened bone fractures or a tumor gets to be very large.

What are secondary bone cancers? 

Secondary bone cancers are those that spread from other parts of the body to the bone. They are cancers that have metastasized, reaching the bone through the body's circulatory system or by extension from nearby tissues. Secondary bone cancers are much more common than cancers that start in the bone. Breast, lung, thyroid, and kidney cancers are those most likely to spread to the skeleton, particularly to the red marrow areas of the skull, spine, ribs, pelvis, shoulders, and upper thighs.

What are the major types of primary bone cancer? 

The major types of primary bone cancer are osteogenic sarcoma, chondrosarcoma, Ewing's sarcoma, fibrosarcoma of the bone, malignant giant cell tumor, chordoma, and parosteal osteosarcoma.

What is osteogenic sarcoma? 

Osteogenic sarcoma is the most common form of bone cancer and develops in a leg or arm bone. It occurs mainly in teenagers.

What is Sarcoma?


What is chondrosarcoma? 

Chondrosarcoma occurs mainly in persons of middle age and usually begins in cartilage of a leg, hip, or rib. It causes tender masses, usually in the knee, trunk, or upper ends of the thighs or shoulders. It can also develop in children, usually in the knee bones. Generally it grows slowly and does not spread to other parts of the body for many years, if at all. Lung metastases are uncommon.

How is chondrosarcoma treated? 

Chondrosarcoma is usually treated by surgery. Depending on the tumor's size and location, either part of the bone or the entire bone is removed. In many cases, adequate surgery requires amputation.

What is Ewing's sarcoma? 

Ewing's sarcoma begins in the marrow spaces inside the midshafts of bones. It usually starts in the bone of the leg, hip, rib, or arm. It is a fast growing cancer that spreads quickly to the lungs and may also spread to other bones. It is usually a children's cancer.

What is fibrosarcoma of the bone? 

Fibrosarcoma of the bone is a very rare cancer that arises in the ends of major limb bones and spreads into soft tissue. It more often affects the middle aged and the elderly. Like other adult sarcomas, it sometimes develops slowly in bones that have been x-rayed many times. In older patients, a usual site is the pelvis; in younger patients, the knee. Surgery is the usual treatment, with the affected bone being removed.

What is giant-cell tumor of the bone? 

Giant-cell tumor of the bone is a benign tumor that sometimes becomes cancerous. Its most common location is in the thigh bone near the knee. It is one of the few bone tumors to which women are more susceptible than men. If the tumor is not cancerous, it and a margin of normal tissue are removed. If the tumor is cancerous, a wider margin of normal tissue must be taken out.

What is chordoma? 

Chordoma is a very rare cancer which occurs in the spinal column or skull. It causes pain and constipation. If it affects the skull, it can affect vision. Chordoma grows slowly and is usually treated with radiation.

What is parosteal osteosarcoma? 

Parosteal osteosarcoma is a very rare cancer involving both the outer part of a limb bone and the membrane which covers the bone. Patients are treated and usually cured by surgery that removes the tumor and a margin of healthy tissue.

What is soft-tissue sarcoma? 

Soft-tissue sarcomas start in muscle, fat, fibrous tissue, blood vessels, or nerves or in other supporting tissue of the body. The term soft tissue refers to the connective tissues that support, surround, and connect the structures of the body. Soft-tissue sarcomas occur mostly in the trunk, head, neck, arms, and legs. They are usually aggressive, with a tendency to invade surrounding tissues and to spread to the lungs.

How are soft-tissue sarcomas treated? 

Although there are many different types of soft-tissue sarcomas, to the doctor planning the treatment, the type is not as important as the cancer's location, and its stage, and whether the patient is an adult or a child.

How are soft-tissue sarcomas of the extremities treated? 

Soft-tissue sarcomas of the extremities occur mainly in adults. Researchers at the National Cancer Institute have found that surgery which saves the limb plus radiation treatment can be offered to most patients instead of amputation. The use of chemotherapy immediately after surgery often leads to marked improvement in freedom from disease recurrence and in possible cure of these patients.

How are soft-tissue sarcomas in the trunk of adults treated? 

These sarcomas are usually treated with surgery and postoperative radiation therapy. There are studies under way using chemotherapy in various combinations.

What is synovial sarcoma? 

Synovial sarcomas usually arise from the synovial tissue of the joints, tendon sheaths, and bursa the fluid filled saclike cavities in tissues that prevent friction from occurring. This type of cancer is rare and occurs in young adults more often than in other age groups. It is usually in the lower extremities, but may be found in other parts of the body. Synovial sarcoma, also known as synovioma, varies greatly in its rate of growth. It sometimes remains in the original area for a long time, without spreading. In some patients, secondary tumors may develop in the lungs. The treatment is usually surgery. Radiation may be added. The tumor may return after surgery. Chemotherapy, together with surgery and radiation, may be used for synovial sarcomas that are found in the extremities.

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