Synchronous tonsillar tumors with differing histopathology: A case report and review of the literature

Rossi, Nicholas A. A.; Reddy, Devin N.; Rawl, Jordan W.; Dong, Jianli; Qiu, Suimin; Clement, Cecilia; Resto, Vicente A.; Joshi, Rohan P.; McKinnon, Brian J.; Coblens, Orly

doi:10.1002/cnr2.1615

Cited by 3 publications

(1 citation statement)

References 29 publications

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“…4 Based on Global Cancer Data, the occurrence rates of second primary cancer in various regions of the head and neck are as follows: 4.3 cases per 100,000 population for the oral cavity, 2.2 for the larynx, 2.0 for the pharynx, and 1.2 for the nasopharynx. 5 Head and neck cancers are reported to have 2.4 to 7% probability of having synchronous tumors. 6 Synchronous tumors present unique challenges compared to metachronous tumors with the latter generally having a more favorable prognosis.…”

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confidence: 99%

Synchronous Primary Head and Neck Tumors: Follicular Thyroid Carcinoma and Squamous Cell Carcinoma of The Tonsil

Maristela,

Cruz

2024

Philipp J Otolaryngol Head Neck Surg

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Simultaneously occurring malignancies may be detected in different organs or tissues at any given time. Patients diagnosed with a tumor may be found to have another tumor or second primary cancer. Second primary cancers (SPCs) may be further classified as synchronous or metachronous. Synchronous SPCs are lesions detected simultaneously or within 6 months after the diagnosis of the primary tumor while metachronous SPCs are tumors diagnosed 6 months after primary tumor diagnosis.1 There is an increased risk of having second primary cancer in Head and Neck Squamous Cell Carcinoma (HNSCC) patients.1 In a study by Strojan et al. in 2013, among 2,106 head and neck cancer patients, 2.4% developed synchronous second primary cancers.2 A systematic review by Coco-Pelaz et al. in 2020, showed that second primary tumors most frequently occur in the head and neck area followed by the lungs and esophagus.3 We present a case of follicular thyroid carcinoma with an incidental finding of cervical lymph node metastatic squamous cell carcinoma from the tonsil and discuss the clinical presentation, ancillary procedures and management.

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Section: Discussionmentioning

confidence: 99%

Synchronous Primary Head and Neck Tumors: Follicular Thyroid Carcinoma and Squamous Cell Carcinoma of The Tonsil

Maristela,

Cruz

2024

Philipp J Otolaryngol Head Neck Surg

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Synchronous tonsillar tumors with differing histopathology: A case report and review of the literature

et al. 2022

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Background Tonsillar squamous cell carcinoma (TSCC) due to human papillomavirus (HPV) infection has seen a dramatic increase in recent years. Bilateral tonsillar squamous cell carcinoma (biTSCC) has a much lower incidence than unilateral TSCC and three main hypotheses of biTSCC pathogenesis prevail: field carcinogenesis, single‐clone, and multiple HPV infections. Case A 49‐year‐old Male with a remote history of chewing tobacco presented with symptoms of spitting up tissue and occasional hemoptysis. Physical exam showed a sole left tonsillar mass which was confirmed to be TSCC on biopsy. The patient's computed tomographic (CT) scan was consistent with this finding; however, positron emission tomography (PET) scan indicated a second tumor in the contralateral right tonsil. Surgical resection of both masses and selective neck dissection was performed, and the specimens were sent for further pathological analysis. No complications of surgery were noted and the final diagnosis of synchronous biTSCC was made. The tumors were a T2N0M0 left poorly differentiated TSCC (p16+, EGFR+, bcl2+) with basaloid features, and a T1N0M0 right well to moderately differentiated TSCC (p16+, EGFR+, bcl2−). Conclusion Our present case was notable for differing tumor pathology and karyotype analysis between the right and left masses, directly supporting the multiple HPV infections hypothesis of biTSCC pathogenesis. Further genetic characterization of tonsillar tumors is needed to better characterize TSCC and best guide medical/surgical therapy.

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Benign and Malignant Tumors of the Tonsils

Vaddi¹,

Renapurkar²,

Khurana³

2023

Tonsils and Adenoids

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Tonsils are lymphoid tissues in the oral cavity and nasopharyngeal region arranged in Waldeyer’s ring. The Waldeyer’s ring consists of pairs of pharyngeal (adenoids), tubal, palatine, and lingual tonsils. These are usually hyperplastic at a younger age and decrease with age. However, asymmetric enlargement might be a sign of pathology. It could be due to tonsillitis, abscess, benign tumors such as fibromas, chondromas, and teratomas, angiomas such as lymphangioma, hemangioma, and inclusion cyst. Benign tumors of the tonsils are usually rare but not uncommon. It could be due to malignancies such as lymphoma, squamous cell carcinoma, or metastasis. This chapter focuses on clinical and radiographic features of common benign and malignant tumors of palatine and lingual tonsils.

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Synchronous tonsillar tumors with differing histopathology: A case report and review of the literature

Cited by 3 publications

References 29 publications

Synchronous Primary Head and Neck Tumors: Follicular Thyroid Carcinoma and Squamous Cell Carcinoma of The Tonsil

Synchronous Primary Head and Neck Tumors: Follicular Thyroid Carcinoma and Squamous Cell Carcinoma of The Tonsil

Synchronous tonsillar tumors with differing histopathology: A case report and review of the literature

Benign and Malignant Tumors of the Tonsils

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