0:01

Hello everyone. Dr.Sidney Levy.

0:02

3 00:00:05,180 --> 00:00:09,370 I'm continuing our discussion of the general imaging

0:09

features and patterns of spread of post-cricoid

0:13

region hypopharyngeal squamous cell malignancies.

0:17

We have our example case here with post-contrast T1-weighted

0:21

imaging with fat suppression on the left, pre-contrast

0:25

T1-weighted imaging without fat suppression in the middle, and

0:29

pre-contrast T1-weighted imaging without fat suppression

0:32

in a sagittal projection on the right.

0:36

I'll just draw the tumor for you.

0:38

So this tumor is originating in the left post-

0:42

cricoid region and can also be appreciated

0:47

on the sagittal projection as an abnormal

0:49

thickening of the post-cricoid space.

0:54

These tumors have a propensity to spread inferiorly into

0:58

the cervical esophagus, as this one has done, remembering

1:01

that the inferior border of the cricoid cartilage is

1:05

the demarcation between the hypopharynx and the esophagus.

1:08

So this tumor is going all the way down into

1:12

the upper cervical esophagus, anterior wall.

1:16

They also have a tendency to spread anteriorly

1:20

into the larynx, and in particular tend to erode

1:24

the posterior wall of the cricoid cartilage.

1:28

So this tumor being centered here closely abuts the

1:34

posterior wall of the cricoid cartilage, which is

1:39

demonstrated here and here, but the tumor itself

1:46

does not macroscopically erode that cartilage.

1:51

So that's a very important finding to

1:53

comment on when reporting a study like this.

1:57

Other than that, they can spread in other

1:59

directions, such as laterally into the apices of

2:03

the piriform sinuses, or around and posteriorly

2:07

to involve the posterior hypopharyngeal wall.

2:12

Superiorly, they can also extend into the supraglottic

2:16

larynx at the level of the laryngeal inlet.

2:19

From a point of view of nodal drainage, these

2:22

tumors have a tendency to spread to levels

2:25

three and four and are often bilateral.

2:30

In summary, post-cricoid region tumors are often

2:35

difficult to distinguish from other tumors in the region.

2:39

and it is helpful to look for abnormal thickening

2:43

or bulging of the soft tissue situated between the

2:48

cricoid cartilage and the posterior hypopharyngeal wall,

2:52

in particular on the axial and sagittal projections.

2:56

They have a tendency to spread to lymph

2:59

nodes in levels three and four and are often

3:02

associated with bilateral nodal disease.

Hypopharynx - Postcricoid Space SCC - Local Spread

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0:01

Hello everyone. Dr.Sidney Levy.

0:02

3 00:00:05,180 --> 00:00:09,370 I'm continuing our discussion of the general imaging

0:09

features and patterns of spread of post-cricoid

0:13

region hypopharyngeal squamous cell malignancies.

0:17

We have our example case here with post-contrast T1-weighted

0:21

imaging with fat suppression on the left, pre-contrast

0:25

T1-weighted imaging without fat suppression in the middle, and

0:29

pre-contrast T1-weighted imaging without fat suppression

0:32

in a sagittal projection on the right.

0:36

I'll just draw the tumor for you.

0:38

So this tumor is originating in the left post-

0:42

cricoid region and can also be appreciated

0:47

on the sagittal projection as an abnormal

0:49

thickening of the post-cricoid space.

0:54

These tumors have a propensity to spread inferiorly into

0:58

the cervical esophagus, as this one has done, remembering

1:01

that the inferior border of the cricoid cartilage is

1:05

the demarcation between the hypopharynx and the esophagus.

1:08

So this tumor is going all the way down into

1:12

the upper cervical esophagus, anterior wall.

1:16

They also have a tendency to spread anteriorly

1:20

into the larynx, and in particular tend to erode

1:24

the posterior wall of the cricoid cartilage.

1:28

So this tumor being centered here closely abuts the

1:34

posterior wall of the cricoid cartilage, which is

1:39

demonstrated here and here, but the tumor itself

1:46

does not macroscopically erode that cartilage.

1:51

So that's a very important finding to

1:53

comment on when reporting a study like this.

1:57

Other than that, they can spread in other

1:59

directions, such as laterally into the apices of

2:03

the piriform sinuses, or around and posteriorly

2:07

to involve the posterior hypopharyngeal wall.

2:12

Superiorly, they can also extend into the supraglottic

2:16

larynx at the level of the laryngeal inlet.

2:19

From a point of view of nodal drainage, these

2:22

tumors have a tendency to spread to levels

2:25

three and four and are often bilateral.

2:30

In summary, post-cricoid region tumors are often

2:35

difficult to distinguish from other tumors in the region.

2:39

and it is helpful to look for abnormal thickening

2:43

or bulging of the soft tissue situated between the

2:48

cricoid cartilage and the posterior hypopharyngeal wall,

2:52

in particular on the axial and sagittal projections.

2:56

They have a tendency to spread to lymph

2:59

nodes in levels three and four and are often

3:02

associated with bilateral nodal disease.

Report

Description

Faculty

Sidney Levy, PhD, MBBS

Radiologist and Nuclear Medicine Specialist

I-MED

Lesson

Oral Cavity Anatomy

Lesson

Oral Cavity Staging of Squamous Cell Malignancy

Lesson

Lymph Node Levels of the Neck

Lesson

Oropharynx

Lesson

Hypopharynx

Lesson

Larynx

Lesson

Sinonasal

Lesson

Perineural Tumor Spread

Hypopharynx - Postcricoid Space SCC - Local Spread