Malignant tumors of the ENT organs: causes, symptoms, diagnosis, treatment

Malignant tumors of the ENT organs can develop from a number of relatively benign growths (malignancy) preceding them, which are called pretumors. In addition to the direct influence of the tumor on the surrounding tissues and organs in which it arose, tumors are also characterized by so-called paraneoplastic syndromes, which are non-specific and accompany not only malignant growth, but also some benign tumors, such as neurinoma of the vestibulocochlear nerve, developing in the internal auditory canal, compressing the nerve trunks corresponding to their localization.

Paraneoplastic syndromes are various pathological manifestations caused by the influence of the tumor process on the metabolism and functional activity of the body's regulatory systems. Most of these syndromes aggravate the course of the tumor process, and in some cases their signs help in diagnosing the disease. Over 60 paraneoplastic syndromes have been described, among which are syndromes with metabolic disorders, endocrine functions, skin lesions, vascular disorders, autoimmune disorders, allergic reactions, CNS lesions, neuromuscular disorders, etc. The frequency of tumors increases with age, and in most cases they occur after 40 years. However, some tumors are more common in children than in adults. These include teratomas - neoplasms from embryonic tissue, tumors from nervous tissue, peculiar kidney tumors (nephroblastomas) and various angiomas - vascular tumors.

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Symptoms of malignant tumors of ENT organs

It is generally accepted that malignant tumors are asymptomatic in the initial stages, but in most cases, with careful and in-depth anamnesis, one or more minor symptoms of a general oncological disease can be identified (deterioration in well-being, increased fatigue, decreased appetite, weakness, etc.), if the tumor or its predecessor - a pretumor - develops in an organ whose function is obvious to both the patient and others (for example, the phonatory function of the larynx), then these minor symptoms must be taken into account in compliance with the principle of oncological alertness. Symptoms of each form of malignant (benign) tumor depend on its location and the degree of spread, which is usually designated according to the International System, where T is the primary tumor focus, N is the lesion of the lymph nodes, M is the presence of hematogenous metastases in distant organs. The severity of each of these signs is characterized by digital indicators. There is a classification in which all clinical manifestations of tumor growth are divided into stages:

• stage I - the tumor is limited to the organ, there are no metastases;
• stage II - the tumor is within the affected organ, there are metastases in the regional lymph nodes;
• stage III - a tumor of significant size with growth into adjacent organs and tissues, there are multiple metastases in regional lymph nodes;
• stage IV - the presence of distant metastases regardless of the size and extent of the primary tumor.

Diagnostics of malignant tumors of ENT organs

Diagnostics of malignant tumors of ENT organs is carried out by the same methods as the recognition of other diseases. The easiest is early recognition of oncological diseases of organs accessible to visual examination, since in this case it is possible not only to examine them, but also to take material for morphological examination. The most difficult is the early diagnosis of tumors of internal organs. In this case, special research methods are of decisive importance: X-ray, radionuclide, morphological, immunological, etc. Research methods using nuclides are increasingly being introduced into clinical practice, called radionuclide diagnostics, which is a method for recognizing pathological changes in human organs and systems using radiopharmaceuticals, which include compounds labeled with radionuclides. Registration of the effects of radionuclides introduced into the body is carried out using scintigraphy, scanning, radiometry, radiography. Scintigraphy, the most common method of radionuclide diagnostics, allows obtaining an image of an organ and judging its size and shape, identifying a lesion in the form of an area of increased or decreased accumulation of the administered radionuclide, assessing the functional state of the organ by the rate of accumulation and excretion of the radiopharmaceutical. The use of radionuclide diagnostics does not pose a danger to the body due to the extremely low dose of the nuclide, its short half-life and rapid excretion. The final stage of diagnostics is a morphological study, which is carried out using histological (biopsy) or cytological methods of examining cells in washes, scrapings from the affected area. According to the method of taking material for histological examination, a distinction is made between incisional, puncture and aspiration biopsy. In this case, preliminary tissue dissection may be required to provide access to a deeply located lesion (open biopsy). In case of tumors of the upper respiratory tract, incisional biopsy is most often used due to the accessibility of the object of study. When examining the trachea and bronchi, aspiration biopsy of sputum and washings is used. Biopsy is performed only in a medical facility, strictly observing aseptic requirements and taking into account the general condition of the patient. The obtained material is immediately placed in a freshly prepared fixing solution containing 1 part formalin and 4-5 parts water, and together with the accompanying document filled out by the doctor, it is delivered to the laboratory of the pathological anatomy department.

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Treatment of malignant tumors of ENT organs

Treatment of malignant tumors of the ENT organs is carried out by various methods, adequate for a given type of tumor, depending on the localization, stage of development, age of the patient, his general condition, etc. The main method is surgical, in which, along with the tumor, part of the healthy surrounding tissues are removed, as well as those suspected of having metastases in the regional lymph nodes. In a large percentage of cases, surgical interventions are supplemented by radiation and drug methods using antitumor agents. In recent years, methods of immunotherapy of malignant tumors have been intensively developed, aimed at activating both general and tumor-specific defenses of the body.

How to prevent malignant tumors of ENT organs?

Malignant tumors of the ENT organs can be prevented in two ways - prevention of the tumor process and prevention of its development. The first way is based on information about blastomogenic agents in the environment. Reducing contact with oncogenic factors leads to a decrease in tumor incidence. The second way is based on the timely detection and treatment of precancerous conditions, which is facilitated by systematic mass preventive examinations of the population.