Neoplasms of the Oropharynx

  • Robert Hermans
Part of the Medical Radiology book series (MEDRAD)


Squamous cell carcinoma is the most common neoplasm originating in the oropharynx. Cigarette smoking and excessive alcohol consumption are well-known risk factors. Infection by high-risk human papillomavirus (HPV) is also a well-recognized risk factor for development of oropharyngeal cancer, and these patients have a better prognosis than those with tobacco or alcohol-induced cancers. As in other head and neck sites, the clinical examination and imaging studies are complementary in the evaluation of the tumor extent. Accurate staging is important in the pretreatment planning of oropharyngeal malignancies. After a review of the normal anatomy, this chapter describes the imaging findings in oropharyngeal cancer, focusing on tumor extent patterns in the different oropharyngeal subsites.


Soft Palate Oropharyngeal Cancer Tongue Base Parapharyngeal Space Lingual Nerve 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Bussels B, Hermans R, Reijnders A, Dirix P, Nuyts S, Van den Bogaert W (2006) Retropharyngeal nodes in squamous cell carcinoma of the oropharynx: implications for target volume delineated. Int J Radiat Oncol Biol Phys 65:733–738PubMedCrossRefGoogle Scholar
  2. Chong VFH, Mukherji SK, Ng SHH et al (1999) Nasopharyngeal carcinoma: review of how imaging affects staging. JCAT 23:984–993Google Scholar
  3. Cohan DM, Popat S, Kaplan SE, Rigual N, Loree T, Hickx WL Jr (2009) Oropharyngeal cancer: current understanding and management. Curr Opin Otolaryngol Head Neck Surg 17:88–94PubMedCrossRefGoogle Scholar
  4. Dirix P, Nuyts S (2010) Evidence-based organ-sparing radiotherapy in head and neck cancer. Lancet Oncol 11:85–91PubMedCrossRefGoogle Scholar
  5. Dubin MG, Ebert CS, Mukherji SK, Pollock HW, Amjadi D, Shockley WW (2002) Computed tomography’s ability to predict sacrifice of hypoglossal nerve at resection. Laryngoscope 112:2181–2185PubMedCrossRefGoogle Scholar
  6. Farina D, Hermans R, Lemmerling M et al (1999) Imaging of the parapharyngeal space. J Belge Radiol 82:234–239Google Scholar
  7. Fletcher GH, Hamberger AD (1974) Causes of failure in irradiation of squamous‐cell carcinoma of the supraglottic larynx. Radiology 111:697–700PubMedGoogle Scholar
  8. Ginsberg LE, DeMonte F (1998) Imaging of perineural tumor spread from palatal carcinoma. Am J Neuroradiol 19:1417–1422PubMedGoogle Scholar
  9. Hermans R, Lenz M (1996) Imaging of the oropharynx and oral cavity. Part I: Normal anatomy. Eur Radiol 6:362–368PubMedGoogle Scholar
  10. Hermans R, Horvath M, De Schrijver T et al (1994) Extranodal non-Hodgkin lymphoma of the head and neck. J Belge Radiol 77:72–77PubMedGoogle Scholar
  11. Hermans R, Op de beeck K, Van den Bogaert W et al (2001) The relation of CT-determined tumor parameters and local and regional outcome of tonsillar cancer after definitive radiation treatment. Int J Radiat Oncol Biol Phys 50:37–45Google Scholar
  12. Hsu WC, Loevner LA, Karpati R et al (2005) Accuracy of magnetic resonance imaging in predicting absence of fixation of head and neck cancer to the prevertebral space. Head Neck 27:95–100PubMedCrossRefGoogle Scholar
  13. Julieron M, Kolb F, Schwaab G et al (2001) Surgical management of posterior pharyngeal wall carcinomas: functional and oncologic results. Head Neck 23:80–86PubMedCrossRefGoogle Scholar
  14. Loevner LA, Ott IL, Yousem DM et al (1998) Neoplastic fixation to the prevertebral compartment by squamous cell carcinoma of the head and neck. Am J Roentgenol 170:1389–1394Google Scholar
  15. Million RR, Cassisi NJ, Mancuso AA (1994) Hypopharynx: pharyngeal walls, pyriform sinus, postcricoid pharynx. In: Million RR, Cassisi NJ (eds) Management of head and neck cancer: a multidisciplinary approach. J.B. Lippincott Co, Philadelphia, p 516Google Scholar
  16. Mukherji SK, Weeks SM, Castillo M et al (1996) Squamous cell carcinomas that arise in the oral cavity and tongue base: can CT help predict perineural or vasculair invasion? Radiology 198:157–162PubMedGoogle Scholar
  17. Mukherji SK, Schmalfuss IM, Castelijns J, Mancuso AA (2004) Clinical applications of tumor volume measurements for predicting outcome in patients with squamous cell carcinoma of the upper aerodigestive tract. Am J Neuroradiol 25:1425–1432PubMedGoogle Scholar
  18. Nathu RM, Mancuso AA, Zhu TC, Mendenhall WM (2000) The impact of primary tumor volume on local control for oropharyngeal squamous cell carcinoma treated with radiotherapy. Head Neck 22:1–5PubMedCrossRefGoogle Scholar
  19. Nuyts S, Dirix P, Clement PMJ, Vander Poorten V, Delaere P, Schoenaers J, Hermans R, Van den Bogaert W (2009) Impact of adding concomittant chemotherapy to hyperfractionated radiotherapy for advanced head-and-neck squamous cell carcinoma. Int J Radiat Oncol Biol Phys 73:1088–1095PubMedCrossRefGoogle Scholar
  20. Portugalli V, Borghesi A, Mossi F, Farina D, Maroldi R (2003) VIBE sequence in the diagnostic work-up of malignant neoplasms of the oropharynx. Scientific poster ECR 2003.
  21. Psyrri A, Gouveris P, Vermorken JB (2009) Human papillomavirus-related head and neck tumors: clinical and research implication. Curr Opin Oncol 21:201–205PubMedCrossRefGoogle Scholar
  22. Righi PD, Kelley DJ, Ernst R et al (1996) Evaluation of prevertebral muscle invasion by squamous cell carcinoma. Can computed tomography replace open neck exploration? Arch Otolaryngol Head Neck Surg 122:660–663PubMedCrossRefGoogle Scholar
  23. UICC, International Union Against Cancer (2009) TNM classification of malignant tumors, 7th edn. Wiley-Liss, New York, pp 30–33Google Scholar
  24. Vandecaveye V, De Keyzer F, Nuyts S, Deraedt K, Dirix P, Hamaekers P, Vander Poorten V, Delaere P, Hermans R (2007) Detection of head and neck squamous cell carcinoma with diffusion weighted MRI after (chemo)radiotherapy: correlation between radiologic and histopathologic findings. Int J Radiat Oncol Biol Phys 67:960–971PubMedCrossRefGoogle Scholar
  25. Watkinson JC, Gaze MN, Wilson JA (2000) Stell & Maran’s head & neck surgery, 4th edn. Butterworth Heinemann, Oxford, pp 322, 338Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2011

Authors and Affiliations

  1. 1.Department of RadiologyUniversity HospitalsLeuvenBelgium

Personalised recommendations