Journal articles: 'Tonsille palatine – Cancer'

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Kim, Tae-Yoon, Ji Young Lee, Young-Jun Lee, Dong Woo Park, Kyung Tae, and Yun Young Choi. "CT texture analysis of tonsil cancer: Discrimination from normal palatine tonsils." PLOS ONE 16, no. 8 (August 11, 2021): e0255835. http://dx.doi.org/10.1371/journal.pone.0255835.

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The purposes of the study were to determine whether there are differences in texture analysis parameters between tonsil cancers and normal tonsils, and to correlate texture analysis with 18F-FDG PET/CT to investigate the relationship between texture analysis and metabolic parameters. Sixty-four patients with squamous cell carcinoma of the palatine tonsil were included. A ROI was drawn, including all slices, to involve the entire tumor. The contralateral normal tonsil was used for comparison with the tumors. Texture analysis parameters, mean, standard deviation (SD), entropy, mean positive pixels, skewness, and kurtosis were obtained using commercially available software. Parameters were compared between the tumor and the normal palatine tonsils. Comparisons were also performed among early tonsil cancer, advanced tonsil cancer, and normal tonsils. An ROC curve analysis was performed to assess discrimination of tumor from normal tonsils. Correlation between texture analysis and 18F-FDG PET/CT was performed. Compared to normal tonsils, the tumors showed a significantly lower mean, higher SD, higher entropy, lower skewness, and higher kurtosis on most filters (p<0.001). On comparisons among normal tonsils, early cancers, and advanced tonsil cancers, SD and entropy showed significantly higher values on all filters (p<0.001) between early cancers and normal tonsils. The AUC from the ROC analysis was 0.91, obtained from the entropy. A mild correlation was shown between texture parameters and metabolic parameters. The texture analysis parameters, especially entropy, showed significant differences in contrast-enhanced CT results between tumor and normal tonsils, and between early tonsil cancers and normal tonsils. Texture analysis can be useful as an adjunctive tool for the diagnosis of tonsil cancers.

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Arvisais-Anhalt, Simone, Andrew Quinn, Justin A. Bishop, Cynthia S. Wang, Ron B. Mitchell, Romaine F. Johnson, Barbara Schultz, and Andrew T. Day. "Palatine Tonsilloliths and Actinomyces: A Multi-institutional Study of Adult Patients Undergoing Tonsillectomy." Otolaryngology–Head and Neck Surgery 163, no. 4 (May 5, 2020): 743–49. http://dx.doi.org/10.1177/0194599820921392.

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Objective To better characterize associations between Actinomyces and tonsillolith versus nontonsillolith tonsillectomy specimens. Study Design Bi-institutional retrospective case-case study. Setting University and county hospital. Subjects and Methods Adult patients with a clinical history of tonsilloliths who underwent tonsillectomy from January 2006 to December 2018 were included. Patients undergoing tonsillectomy for tonsillar hypertrophy and chronic tonsillitis were identified as comparative cases. Similarly, patients with ipsilateral oropharyngeal cancer (OPC) who underwent contralateral tonsillectomy of a normal-appearing tonsil for prophylaxis against a second primary cancer were also included as comparative cases. Results The study population comprised 134 patients who underwent tonsillectomy: 62 tonsillolith and 72 nontonsillolith (tonsillar hypertrophy, n = 30; chronic tonsillitis, n = 30; normal-appearing contralateral tonsil in patients with ipsilateral OPC, n = 12). Actinomyces was reported in 11% of the patients with tonsilloliths on initial pathology reports but in 95% after re-evaluation (n = 54 of 57). Actinomyces prevalence was significantly higher in patients with tonsilloliths as compared with patients with recurrent tonsillitis (73%, n = 22 of 30, P < .001) and normal-appearing contralateral tonsils in patients with ipsilateral OPC (58%, n = 7 of 12, P < .001). Actinomyces prevalence was not significantly different between patients with tonsilloliths and tonsillar hypertrophy (83%, n = 25 of 30, P = .11). Conclusion The prevalence of Actinomyces in tonsillolith tonsil specimens is high; however, Actinomyces routinely colonizes nontonsillolith tonsil specimens. Therefore, Actinomyces is unlikely to be the primary driver of tonsillolith pathogenesis, and Actinomyces-targeted treatment of tonsilloliths may not be effective. Treatment strategies addressing tonsilloliths should be further investigated.

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Kaczmarczyk, Dariusz, Dawid Zagacki, Marcin Braun, and Alina Morawiec-Sztandera. "Gastric carcinoma metastasis to the palatine tonsil – case report." Polski Przegląd Otorynolaryngologiczny 9, no. 1 (March 20, 2020): 50–53. http://dx.doi.org/10.5604/01.3001.0014.0309.

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Aim: The aim of the study is to present a rare case of metastatic tumor localized in pharyngeal tonsil being the first symptom of gastric carcinoma. Case report: Retrospective analysis of medical documentation was performed. A 44-years-old men was referred to the Department presenting a complaint of enlarged right pharyngeal tonsil. The mass was not painful. Patient reported tobacco smoking (20/day) for many years. In the intraoral examination a 2 cm right palatine tonsil was present. There was a slight asymmetry between tonsils. Local lymph nodes were not enlarged. FNAC was performed stating suspicion of carcinoma. Patient was qualified for the tonsillectomy under general anesthesia. Histopathological finding was adenocarcinoma (G2) infiltration. Due to no correlation of clinical presentation and histopathological finding PET-CT examination was performed revealing massive gastric infiltration, tumor of the left adrenal gland, increased 18-FDG uptake in epigastrial and para-aortic lymph nodes. Gastroscopy and biopsy was performed. Histopathological material confirmed adenocarcinoma presenting the same immunotype as tonsillar. Patient was qualified for paliative treatment. He died 6 weeks after stating the diagnosis. Metastases to the pharyngeal tonsils constitute rare disease entities. Mostly the primary site is localized in the region of head and neck. In our case the metastatic tumor of the right tonsil was the first sign of the gastric cancer.

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Serra, A., R. Caltabiano, G. Scalia, S. Palmucci, P. Di Mauro, and S. Cocuzza. "Papillary squamous cell carcinoma of the palatine tonsil: a rare cancer of the head and neck." Acta Otorhinolaryngologica Italica 37, no. 4 (August 2017): 341–45. http://dx.doi.org/10.14639/0392-100x-1281.

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Le neoplasie squamose papillari delle vie aeree digestive superiori sono una rara variante del carcinoma a cellule squamose. Sono caratterizzate da una crescita esofitica papillare e hanno una prognosi generalmente favorevole. Il tumore è già stato descritto a livello delle vie aeree digestive superiori. In tale contesto, le localizzazioni più frequenti sono la laringe e lipofaringe, mentre raramente sono interessati la cavità orale e lipofaringe. Gli studi limitati unitamente allesiguo numero di casi pubblicati di carcinoma squamoso papillare a localizzazione tonsillare, ci hanno indotto a una completa analisi di questo tumore, analizzando gli aspetti clinici, istopatologici, radiologici, virologici e terapeutici, non sempre presenti in letteratura. Un case report di carcinoma squamoso papillare della tonsilla palatina è pertanto riportato. La lesione (T2N0M0), localizzata a livello della tonsilla palatina sinistra, si aggettava verso la cavità orale. HPV DNA 16 e mRNA E6/E7 erano rilevati nella lesione. Un profilo della neoplasia è pertanto presentato unitamente a una completa revisione della recente letteratura, analizzando tutti gli aspetti di interesse di tale neoplasia.

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Aloyouny, Ashwag Yagoub. "Unusual Site for a White Nodule on the Palatine Tonsil: Presentation, Differential Diagnosis, and Discussion." Case Reports in Dentistry 2021 (July 8, 2021): 1–4. http://dx.doi.org/10.1155/2021/1371329.

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Introduction. Palatine tonsils are part of the mucosa-associated lymphoid tissue, located in the oropharyngeal region. Although these tissues protect the body from foreign intruders, they are more prone to infections due to their anatomical structure and location. For instance, the differential diagnosis of a white lesion on the palatine tonsil can range from benign to malignant lesions. Oral lymphoepithelial cysts commonly arise as painless, yellowish nodules on the floor of the mouth and the ventral or lateral surface of the tongue. Case Presentation. This paper presents a rare case of an unusual site of a lymphoepithelial cyst (LEC) in the oral cavity. The lesion was located in the tonsil of a 20-year-old woman with a chief complaint of a painless, white lump in the back of the mouth for nine months. Discussion. The differential diagnosis of a white lesion on the palatine tonsil is caused by several factors, such as bacterial, viral, and fungal infections; trauma; stones; cysts; abscess; or cancer. In this case, both the clinical presentation and extra- and intraoral examinations were highly associated with LEC. Oral LEC etiopathogenesis is uncertain, and several theories have been proposed to discuss the causes of LEC. In addition, oral LEC could be monitored without surgical intervention if the nodule is asymptomatic. Conclusion. We emphasize the importance of a thorough clinical examination of oral and oropharyngeal lesions, which are usually neglected.

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Astl, Jaromír, Richard Holy, Eva Maute, Jan Rotnágl, David Kalfeřt, Barbora Drnková, Temoore Younus, and Emil Pavlík. "Genome of Helicobacter pylori and Serotype of HPV Detected in Oropharyngeal and Laryngeal Cancer and Chronic Inflammation Patients." International Journal of Environmental Research and Public Health 18, no. 18 (September 10, 2021): 9545. http://dx.doi.org/10.3390/ijerph18189545.

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Objective: Oropharyngeal/laryngeal carcinoma are common cancers of the upper aerodigestive system. Human papillomavirus (HPV) is described as the most frequent in the cancer of unknown primary. The presence of Helicobacter pylori (HP) in the oral cavity is discussed in some papers. The aim of study: To analyze the incidence of HPV and HP in oropharyngeal/laryngeal cancer persons versus persons with chronic tonsillar inflammation and healthy persons. Methods: The samples were taken in three groups: (1) tissue of oropharynx/larynx cancer (103 specimens); (2) tissue of palatine tonsils (85 specimens); and (3) healthy control group (50 specimens). We analyzed the presence of HP (PCR) and HPV genomic DNA (Sacace HPV High-Risk Screen Real-TM Quant) in the samples. Results: HP was detected in 86 samples (83.5%) and high-risk HPV in 62 samples (60.2%). We found a very high incidence of HP. In the cancer group, HP was detected in 82.5% cases and HPV positivity in 57.8%. In total, 7.2% of the cancer patients were negative for HP and HPV together. In turn, 53.6% of the cancer patients were positive for HP and HPV together. Four cases (4.2%) were positive for HPV only. VacA positivity was detected in 82 (79.6%) of the cancer cases and VacA negativity in 21 (20.4%) if the cancer cases. The incidence of HP in chronic inflammation (n = 85) was 65 cases (76.5%) and the incidence of HPV was 38 cases (44.7%). VacA positivity was detected in 59 (69.4%) of the chronic inflammation cases and VacA negativity was found in 26 (30.6%) of the chronic inflammation cases. Regarding the control group, we found HP positivity in 5 cases (11.1%) and HPV positivity in 19 cases (42.2%). There was VacA positivity in 6 cases (50.0%) of the control group. Statistically significantly lower prevalence of HP (p < 0.001) and HPV (p = 0.006) was found in the control group. Conclusions: We suggest that the palatine tonsils are colonized by HP. In our study, HP was present in oropharyngeal cancer in more cases in comparison with HPV infection. The presence of VacA from HP can have an influence on the human epithelial and immune cells’ regulation ways. Our results do not support idea that the CagA-positive HP is a primary carcinogen in oropharyngeal area.

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Ishikawa, Yasuyuki, and Masanao Okawa. "Primary multiple cancers of the palatine tonsil and parotid gland." Practica Oto-Rhino-Laryngologica 78, no. 11 (1985): 2359–65. http://dx.doi.org/10.5631/jibirin.78.2359.

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Spellman, Joseph, Ryan Sload, Paul Kim, Peter Martin, and Gabriel Calzada. "Staging Neck Dissection and Transoral Robotic Surgery Treatment Algorithm in Palatine Tonsil Cancer." Otolaryngology–Head and Neck Surgery 158, no. 3 (November 21, 2017): 479–83. http://dx.doi.org/10.1177/0194599817742615.

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Objective This study introduces a treatment algorithm based on staging neck dissection to identify patients with palatine tonsil squamous cell carcinoma who can be effectively treated with single-modality transoral robotic surgery while maintaining quality of life. Study Design Retrospective case series. Setting Kaiser Permanente Southern California Medical Group from 2012 to 2017. Subjects and Methods Patients with early-stage (T1/2) palatine tonsil squamous cell carcinoma with clinically and radiographically N0 necks underwent staging neck dissection. Those with pN2/3 disease or extracapsular extension on final pathology were triaged to definitive chemoradiation treatment. Patients with confirmed pN0/1 necks without extracapsular extension were treated definitively with transoral robotic surgery. Results Nineteen patients with cN0 disease underwent selective neck dissection. All were p16 positive. Of these, 14 had pathologically confirmed N0/1 necks without extracapsular extension and were treated with primary surgical resection via transoral robotic surgery. Clear margins were obtained on all patients. There were no significant intra- or postoperative complications. No patients required gastrostomy tube or tracheostomy placement. Mean and median follow-up was 28 months with no recurrences to date. Conclusion Up-front staging neck dissection accurately triages low-risk patients, determining candidates for single-modality definitive treatment with transoral robotic surgery. This approach provides excellent survival outcomes and minimal morbidity and maintains quality of life among appropriately selected patients with palatine tonsil cancer.

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Vrînceanu, Daniela, M. Dumitru, and Carmen Maria Ardeleanu. "MALIGNIZED BRANCHIAL CYST OR CERVICAL METASTATIC ADENOPATHY WITH PRIMARY TUMOR IN A TONSILLAR HIDDEN CARCINOMA?" Journal of Surgical Sciences 7, no. 1 (January 24, 2020): 169–74. http://dx.doi.org/10.33695/jss.v7i1.306.

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Cancer of occult origin is defined as a group of primary tumors with metastatic determinations, most commonly lymph nodes for which diagnostic algorithms fail to identify the place of origin of the primary tumor at the time of positive metastasis diagnosis. Squamous cell carcinoma with a truly unknown primary office is a relatively rare entity in the region of the head and neck. Retrospective studies suggest that it accounts for 1-3% of new cases of squamous cell carcinoma of the head and neck. We will present the clinical case of a 76-year-old patient with metastatic left-cervical cystic metastatic adenopathy, initially interpreted as a malignant branchial cyst. Discrepancies in histopathological examination, imaging and clinical examination delayed the performance of adjuvant radiotherapy. We will present details of diagnosis and evolution of the case. The results of the systematic literature review suggest that palatal tonsillectomy has a high overall rate of detection of subclinical primary tumors. Given the significant number of bilateral / contralateral occult tonsil tumors reported in the specialty literature, bilateral tonsillectomy should be considered in determining the diagnosis of squamous cell carcinoma patients of unknown primary origin in the head and neck. Cervical lymph node metastasis with unknown primary tumor remains a difficult topic for head and neck oncology. Most diagnostic and treatment protocols recommend unilateral or bilateral tonsillectomy, with an increased chance of finding an occult tumor in the palatine, unilateral or bilateral tonsils. In the presence of a cystic cervical lymph node metastasis, the first location should be considered as the primary tumor site must be the palatine tonsil.

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Golas, Sylvia M. "Trends in palatine tonsillar cancer incidence and mortality rates in the United States." Community Dentistry and Oral Epidemiology 35, no. 2 (April 2007): 98–108. http://dx.doi.org/10.1111/j.1600-0528.2007.00299.x.

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Dawson, George Anthony, Yue Hua Zhang, Angela Laurio, Patricia Smith, Michael Dellatto, Fiona T. Innis-Gordon, and Anthony Reino. "The demography of human papillomavirus (HPV) infections in oropharyngeal cancer patients from 2011-2016: A single Veteran Administration institution." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): e17532-e17532. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.e17532.

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e17532 Background: Human papilloma virus (HPV) is a known biologic (viral) carcinogen and has a predilection for tissue in head and neck sites- HPV types 16/18. Current NCCN guidelines recommend HPV testing on newly diagnosed cancers - Head and Neck region - specifically the oropharynx. Methods: After IRB approval, data from our center ranging from 01/01/2011 to 12/31/2016 were collected by using international classification codes (ICD-9) 142, 143, and 146. We enrolled 81 patients for review from of these anatomic sites: Base of tongue, Tonsils, Posterior hypo-pharyngeal wall, soft palate and unknown primary + neck nodes. Data collected: HPV status / age / stage at diagnosis. Risk factors collected were marital status, ethnicity, age, alcohol and tobacco use, and other co-factors. Results: A total of 73 of 81 cases met our criteria for inclusion into review: excluded - 5 with Non-Hodgkin’s lymphoma; 1 with plasma cell neoplasm; 2 excluded - p16 testing only. All enrollees were male. Age range 45 - 91. Mean age: HPV + 64.11 / HPV – 66.76yrs. Anatomic site:BOT-35(48%) /Tonsil-25 (34%) /unknown primacy- 6(8%) /Soft palate– 4(0.05%) /Hypo-pharnyx-3(0.04%). Ethnicity: Non-Hispanic White– 32(44%) /Black-19(26%) /Hispanic – 20 (27%) /American Indian – 1(0.01%) /Unknown – 0. Seventy-three tested for HPV: 36 pos (49%) /37 neg (51% ). Whites were of 49% HPV+. HPV16/18+ in 34 of 36 (94%) tumors. Tobacco exposure ever:32/37(75%) HPV + and 26/36 (75%) HPV - groups. Alcohol use ever: HPV+ 75%; HPV – 67%. Location:BOT/Tonsils were 32/36 (80%) HPV+ cases and 27/37(73%) of HPV – cases. HPV + Marital status: Married 9 (26%) / Never mar 9/Divced 15/Sep 2/Wid 1 - 74% not married. HPV – 37: Married 12 (32%) /Never mar 9 /Divced 9/Sep 5/Wid 2 – 68% not married. Conclusions: HPV +16/18 (34 of 36) infections in our patients (73) were 49% of the overall group. BOT and Tonsil cancers most were the common sites in both groups (+/-). Compared to non-VA patients, our HPV + group used more alcohol and smoked more, and were older - though both groups (+/-) had high usage rates. We noted more divorcees, and lower marriage rate in the HPV+ group. Whites were 44% overall but 49% of HPV + group.

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Massaccesi, Mariangela, Alessio G. Morganti, Giovanni Serafini, Alessandra Di Lallo, Francesco Deodato, Vincenzo Picardi, and Giovanni Scambia. "Late Tonsil Metastases from Renal Cell Cancer: A Case Report." Tumori Journal 95, no. 4 (July 2009): 521–24. http://dx.doi.org/10.1177/030089160909500420.

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The occurrence of renal carcinoma metastasis to the head and neck region is extremely rare. Some authors have reported metastasis of renal cell carcinoma to the parotid glands, nose and paranasal sinus, tongue, larynx, thyroid and palatine tonsil. In this report we describe a rare case of renal cell cancer metastasized to the right tonsil in a 76-year-old man with previously diagnosed bone and lung metastases. To the best of our knowledge this is the first documented example of radiotherapy treatment in this type of presentation. Radiotherapy was effective in treating the lesion with satisfactory functional results.

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D’Antonio, Chiara, Alberto Lombardini, Concetta Elisa Onesti, Rosa Falcone, Adriana Romiti, Marianna Lombardi, Salvatore Lauro, and Paolo Marchetti. "A rare case of palatin tonsillar metastasis from small cell lung cancer." Translational Lung Cancer Research 5, no. 6 (December 2016): 709–11. http://dx.doi.org/10.21037/tlcr.2016.11.07.

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Pietrzak, Agata, Andrzej Marszalek, Malgorzata Paterska, Pawel Golusinski, Julitta Narozna, and Witold Cholewinski. "Initial and Delayed Metabolic Activity of Palatine Tonsils Measured with the PET/CT-Dedicated Parameters." Diagnostics 10, no. 10 (October 17, 2020): 836. http://dx.doi.org/10.3390/diagnostics10100836.

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One of the most critical elements in the palatine tonsils (PT) patients’ management is to distinguish chronic tonsillitis and malignant tumor. The single-time-point (STP) 2-deoxy-2-[18 F]fluoro-D-glucose positron emission tomography/computed tomography (18 F-FDG PET/CT) examination offers the most significant sensitivity and specificity in the head and neck (H&N) region evaluation among commonly used methods of imaging. However, introducing dual-time-point (DTP) scanning might improve the specificity and sensitivity of the technique, limited by the 18 F-FDG non-tumor-specific patterns, especially when comparing different metabolic parameters. The study aims to compare several surrogates of the maximal standardized uptake value (SUVmax), obtained in 36 subjects, divided into confirmed by pathologic study PT cancer and tonsillitis in patients who underwent DTP 18 F-FDG PET/CT scanning. In this study, we observed the increased sensitivity and the specificity of the DTP 18 F-FDG PET/CT when compared with the standard PET/CT protocol. It could be concluded that DTP 18 F-FDG PET/CT improves the PT cancer and chronic tonsillitis differential diagnosis.

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McHugh, Jonathan B. "Association of Cystic Neck Metastases and Human Papillomavirus–Positive Oropharyngeal Squamous Cell Carcinoma." Archives of Pathology & Laboratory Medicine 133, no. 11 (November 1, 2009): 1798–803. http://dx.doi.org/10.5858/133.11.1798.

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Abstract Human papillomavirus is an established cause of oropharyngeal squamous cell carcinoma. Similar to cervical cancer, these cancers are usually caused by high-risk human papillomavirus types 16 and 18 and are associated with high-risk sexual behaviors. Human papillomavirus–associated oropharyngeal squamous cell carcinoma typically affects the palatine and lingual tonsils and frequently results in cystic neck metastases. The histopathology of this subset of head and neck squamous cell carcinoma is unique and typically characterized by poorly differentiated, nonkeratinizing morphology with a basaloid appearance. These tumors occur in younger patients and are more often seen in nonsmokers compared with conventional oral cavity and oropharyngeal squamous cell carcinomas. The incidence of human papillomavirus–associated squamous cell carcinoma is increasing. Recognition of this unique clinicopathologic subset of head and neck carcinoma is important because these patients typically respond more favorably to organ-sparing treatment modalities and have an improved prognosis.

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Dutsch-Wicherek, Magdalena, Agata Lazar, Romana Tomaszewska, Kornelia Kliś, Konrad Dziobek, and Łukasz Wicherek. "RCAS1 and B7H4 antigens immunoreactivity in squamous cell carcinoma of palatine tonsils and cancer microenvironment." Medical Research Journal 3, no. 3 (November 15, 2018): 134–41. http://dx.doi.org/10.5603/mrj.a2018.0022.

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Vuletić, Marko, Ivica Pelivan, and Dragana Gabrić. "Implant Prosthodontic Rehabilitation after Surgical Treatment for an Oropharyngeal Malignant Tumour Using Tantalum Dental Implants." Case Reports in Dentistry 2021 (April 22, 2021): 1–6. http://dx.doi.org/10.1155/2021/5585181.

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Oropharyngeal cancer (OPC) represents a significant portion of head and neck cancers. In most cases, it is localised in the soft palate, lingual and palatine tonsils, base of the tongue, and the surrounding tissues. Alcohol and tobacco exposure are well-known evidence-based risk factors for developing OPC; however, over the last decade, there has been a rapid increase in OPC linked to human papillomavirus (HPV). Dental implant therapy faces many challenges related to immediate and long-term success, and patients who are rehabilitated with implant prosthodontic therapy often have numerous comorbidities. Tantalum is a rare transitional metal element which has high corrosion resistance and is extremely inert. Porous tantalum trabecular metal (PTTM) has high volumetric porosity, a low modulus of elasticity, and very high friction. PTTM implant surface enhancement allows “osseoincorporation,” which means the neovascularisation and formation of new bone directly onto the implant. A 65-year-old patient presented to the Department of Oral Surgery of Clinical Hospital Centre Zagreb after resection of the mandible due to OPC had oral rehabilitation. Three Zimmer Biomet Trabecular Metal™ implants ( 4.1 × 10 mm ) were inserted in the area of lower left first incisor, lower left second premolar, and lower right second premolar, and after four months, a new upper partial denture and the bar-retained mandibular overdenture were made. Implant prosthodontic rehabilitation of head and neck cancer patients is usually challenging in terms of achieving an improvement in its main aim, quality of life; however, today it is a safe and reliable therapy. Although radiation therapy may negatively affect the patient’s oral condition and influence the short- and long-term success of the implant, the presented case report showed that the excellent properties of PTTM-enhanced dental implants may give great basis for future comparative researches of using these implants in the treatment of oncologic patients.

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Attner, Per. "HPV prevalence in the different subsites of the oropharynx." Journal of Clinical Oncology 31, no. 15_suppl (May 20, 2013): 6037. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.6037.

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6037 Background: Oropharyngeal cancer patients are often reported as one group in articles and studies regardless that within the subsites of the oropharynx, there are differences regarding clinical features, treatment and HPV prevalence. To investigate these differences, we wanted to further analyze HPV prevalence in the different subsites of the oropharynx. Methods: We identified all patients diagnosed with oropharyngeal cancer in Stockholm County, Sweden, between 2000 and 2007, using the Swedish Cancer Registry, a registry unique in its reliability. Using the ICD 10 codes C01.9 (base of tongue cancer), C09.0-C09.9 (tonsillar cancer) and C10.0-C10.9 (oropharyngeal cancer) and C50.1-C50.8 (cancer of the soft palate). The two last subsites were grouped together into the group Other Oropharyngeal Cancer (OOC). We retrieved pre-treatment biopsies and tested for HPV-DNA using PCR, both with general primers and HPV16 specific primers. Results: We identified 474 patients diagnosed with oropharyngeal cancer in Stockholm County, Sweden between 2000 and 2007; 290 diagnosed with tonsillar cancer, 109 diagnosed with base of tongue cancer and 75 diagnosed with other oropharyngeal cancer. Of these 474 patients, pre-treatment biopsies for HPV-testing were available for 400 patients (236, 95 and 69, respectively). In the tonsillar cancer group, 185 biopsies were HPV-DNA-positive (79%), in the base of tongue cancer group 71 (75%) and in the other oropharyngeal cancer group 17 were positive (25%) Conclusions: Tonsillar and base of tongue cancer share some similarities and HPV prevalence is similarly high in both groups. Other oropharyngeal cancer (OOC) does not share the high HPV-prevalence and it would then be preferred that the sub-sites of the oropharynx are reported separately.

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Nikkuni, Osamu, Masami Suzuki, Tomoyuki Kawada, Kohtaro Eguchi, and Ryuhei Okada. "Primary lung cancer with metastasis to the palatine tonsil: a case report and clinical features." Toukeibu Gan 42, no. 1 (2016): 34–38. http://dx.doi.org/10.5981/jjhnc.42.34.

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Torre, Valerio, Sebastiano Bucolo, Carlo Giordano, Rocco Cicciarello, Vittorio Cavallari, Loredana Garofalo, and Fabio Beatrice. "Palatine tonsils in smoker and non-smoker patients: a pilot clinicopathological and ultrastructural study." Journal of Oral Pathology and Medicine 34, no. 7 (August 2005): 390–96. http://dx.doi.org/10.1111/j.1600-0714.2005.00319.x.

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Gorbunova, Tatiana V., Elena Iu Radtsig, Oleg A. Merkulov, Mikhail R. Bogomil’skii, and Vladimir G. Poliakov. "Virus-associated pharynx tumors in a 16-year-old boy: the description of the clinical case." Journal of Modern Oncology 22, no. 2 (July 15, 2020): 137–41. http://dx.doi.org/10.26442/18151434.2020.2.200119.

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Objectives. The relationship between the development of the number of malignant tumors in children and viruses is well known. The etiological role of the EpsteinBarr virus in the development of undifferentiated nasopharyngeal cancer (NPC) has been well studied. The effect of human papillomavirus (HPV) on the occurrence and development of NPC in children is not sufficiently understood. Aim. The description of the clinical case of the Epstein Barr virus and HPV infection in 16-year-old patient with the consistent development of NPC and oropharyngeal papillomatosis. Description of the clinical case. The clinical observation of the boy who was diagnosed with NPC. The full clinical effect in the form of reduction of the primary tumor and metastases in the lymph nodes of the neck was noted after chemo- and radiotherapy. 18 months after the cure according to the positron emission tomography, combined with computed tomography, with 18F-deoxyglucose we marked the accumulation of radiopharmaceuticals in the area of the left palatine and lingual tonsils. The examination revealed clinical signs of the soft palate papillomatosis. The resection of the soft palate was carried out. The morphological study confirmed squamous cell papilloma. HPV type 16 DNA was found in the papilloma. Conclusion. The accumulation of the information concerning childhood pharynx lesions caused by HPV would help to expand understanding of the most common types of the virus in the paediatric population. It would be possible to identify the groups of risk for the development of malignant tumors on the grounds of the detection HPV types of highly carcinogenic risk.

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Charfi, Lamia, Thomas Jouffroy, Patricia de Cremoux, Nelly Le Peltier, Martine Thioux, Paul Fréneaux, Daniel Point, Angélique Girod, José Rodriguez, and Xavier Sastre-Garau. "Two types of squamous cell carcinoma of the palatine tonsil characterized by distinct etiology, molecular features and outcome." Cancer Letters 260, no. 1-2 (February 2008): 72–78. http://dx.doi.org/10.1016/j.canlet.2007.10.028.

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Lin, Alexander J., Yuan James Rao, Re-I. Chin, Jian Campian, Daniel Mullen, Dinesh Thotala, Mackenzie Daly, et al. "Post-operative radiation effects on lymphopenia, neutrophil to lymphocyte ratio, and clinical outcomes in palatine tonsil cancers." Oral Oncology 86 (November 2018): 1–7. http://dx.doi.org/10.1016/j.oraloncology.2018.08.008.

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Matthews, J. B., A. J. C. Potts, and L. K. Trejdosiewicz. "Relationship between fibronectin and lymphoid cells in buccal mucosa, labial salivary glands and palatine tonsil." Journal of Oral Pathology and Medicine 15, no. 2 (February 1986): 103–8. http://dx.doi.org/10.1111/j.1600-0714.1986.tb00586.x.

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Lin, A. J., Y. J. Rao, R. I. Chin, J. L. Campian, D. Mullen, D. Thotala, M. D. Daly, et al. "Postoperative Radiation Effects on Lymphopenia, Neutrophil to Lymphocyte Ratio, and Clinical Outcomes in Palatine Tonsil Cancers." International Journal of Radiation Oncology*Biology*Physics 100, no. 5 (April 2018): 1391. http://dx.doi.org/10.1016/j.ijrobp.2017.12.216.

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Chen, Bo-Nien, Chih-Yung Yang, and Shiuan-Li Wey. "Small Cell Neuroendocrine Carcinoma of the Palatine Tonsil After Concurrent Chemoradiotherapy for Laryngeal Cancer: A Rare Case Report." Acta Scientific Otolaryngology 3, no. 8 (July 8, 2021): 54–57. http://dx.doi.org/10.31080/asol.2021.03.0296.

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Ibarra, A., F. Las Heras, L. Antonio, P. Montero, P. Besa, J. Henriquez, and Y. Labra. "Ciliated Carcinoma Associated With Human Papiloma Virus: Presentation As Cervical Metastasis Of Unknown Primary." American Journal of Clinical Pathology 154, Supplement_1 (October 2020): S34. http://dx.doi.org/10.1093/ajcp/aqaa161.069.

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Abstract Introduction/Objective There is a significant increase in high-risk human papilloma virus (HPV) -related carcinomas of the head and neck. Half of them debut with metastases in cervical nodes, of expansive growth, usually cystic-necrotic. Most are oropharyngeal primaries. They are non-keratinizing squamous carcinomas with mild atypia, sometimes with exceptional characteristics, such as glandular differentiation and inclusion of ciliated cells Methods Clinical Case: 39-year-old male patient, operated two years ago, in another institution, for cervical metastasis from HPV-related Ciliated Carcinoma (HPV-RCC), 4.5 x 2 cm. No primary cancer was found in his study. Two months ago, a new 4.3 x 2.7 cm metastasis was resected, performing a right cervical dissection, with another 36 lymph nodes without tumor. Palatine tonsils, adenoids are removed and a biopsy of the oral mucosa is taken, and no malignancy was found. In our center, biopsies of the tongue and right glosso-tonsillar fold are taken, without objectify malignancy. Results The metastases had macroscopic cystic-necrotic appearance. Histology corresponded to nonkeratinizing squamous carcinoma with microcystic spaces and the presence of ciliated columnar cells. The immunohistochemical study gave strong and diffuse positivity for p16. The real-time multiple PCR study detected HPV genotype 16. Conclusion We present an exceptional case of Ciliated Carcinoma Related to HPV, a recently described entity. These are nonkeratinizing squamous neoplasms, which include cystic spaces and ciliated columnar cells. Both components reveal HPV positivity, with p16 expression and high-risk viral typing. HPV-RCC should be considered in the differential diagnosis of well-differentiated squamous lesions of the oropharyngeal cavity and at the cervical level, with non-neoplastic cysts. Our patient will undergo radiotherapy protocol, for unknown primary

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Colangelo, Laura A., Barbara Roa Pauloski, Jerilyn A. Logemann, David W. Stein, Quinter C. Beery, Mary Anne Heiser, and Salvatore Cardinale. "Effects of Intraoral Prostheses on Speech in Oropharyngeal Cancer Patients." American Journal of Speech-Language Pathology 5, no. 4 (November 1996): 43–55. http://dx.doi.org/10.1044/1058-0360.0504.43.

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This study investigates specific articulatory problems and compromised speech intelligibility associated with and without the use of an intraoral prosthesis in 13 surgically treated oropharyngeal cancer patients. Ten patients had tonsil and varying amounts of posterior tongue, tongue base, and soft palate resected. Three other patients had soft palate resected with no involvement of oral tongue or tongue base. Three types of intraoral prostheses were employed. One type was a maxillary reshaping/lowering prosthesis, the second type was a soft palate obturator, and the third type was a combined maxillary reshaping/lowering and soft palate obturator prosthesis. Review of the individual cases in relation to improvements in articulation and conversational understandability revealed mixed success with prosthesis usage in the group of 10 patients with posterior resection. In the group of three patients with soft palate resection, however, two patients benefitted from use of obturators. The results identify the need for some criteria in patient selection for intraoral prosthetic rehabilitation. However, in view of the individuality of each patient case in terms of surgical deficit, patient characteristics, and varied prosthodontic/speech-language pathologist teams, it is impossible to develop prescriptions for prosthodontic construction based on surgical deficit alone.

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Fakhry, Carole, and Maura L. Gillison. "Clinical Implications of Human Papillomavirus in Head and Neck Cancers." Journal of Clinical Oncology 24, no. 17 (June 10, 2006): 2606–11. http://dx.doi.org/10.1200/jco.2006.06.1291.

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Human papillomavirus (HPV) is now recognized to play a role in the pathogenesis of a subset of head and neck squamous cell carcinomas (HNSCCs), particularly those that arise from the lingual and palatine tonsils within the oropharynx. High-risk HPV16 is identified in the overwhelming majority of HPV-positive tumors, which have molecular-genetic alterations indicative of viral oncogene function. Measures of HPV exposure, including sexual behaviors, seropositivity to HPV16, and oral, high-risk HPV infection, are associated with increased risk for oropharyngeal cancer. HPV infection may be altering the demographics of HNSCC patients, as these patients tend to be younger, nonsmokers, and nondrinkers. There is sufficient evidence to conclude that a diagnosis of HPV-positive HNSCC has significant prognostic implications; these patients have at least half the risk of death from HNSCC when compared with the HPV-negative patient. The HPV etiology of these tumors may have future clinical implications for the diagnosis, therapy, screening, and prevention of HNSCC.

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Ahmadi, Aslan, Saleh Mohebbi, Masoud Kazemi, and Ayda Sanaei. "Transoral Laser-Assisted Total Laryngectomy: Expanding the TLM’s World." Case Reports in Otolaryngology 2020 (September 26, 2020): 1–5. http://dx.doi.org/10.1155/2020/8827139.

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Introduction. The introduction of laryngeal transoral procedures has created a shift in the treatment of laryngeal cancers towards the primary surgical management of patients. In this study, we aimed to evaluate the safety, efficacy, and feasibility of the transoral laser-assisted total laryngectomy (TLM-TL) in advanced laryngeal cancer. Case presentation. In this case report, we describe a case of a 50-year-old male patient presented to the otorhinolaryngology clinic with a history of hoarseness and odynophagia since 6 months. Based on the pathological and imaging findings, the diagnosis of stage IVa laryngeal squamous cell carcinoma with the involvement of the base, tongue, and left palatine tonsil was made for the patient, and transoral total laryngectomy with partial glossectomy via the TLM technique was planned. Result. The tumor was successfully resected by TLM-TL with clear surgical margins. No complication was observed after the surgery. Good functional recovery was obtained regarding swallowing and speech. The patient’s oncologic and functional outcomes were evaluated for 2 years. Everything was satisfactory with good long-term cosmetic and laryngopharyngeal functional outcome and no sign of tumor recurrence. Conclusions. TLM-TL is a minimally invasive and cost-benefit endoscopic surgical procedure feasible in advanced laryngeal cancer with good long-term oncological and functional outcome. It could limit postoperative complications, mainly the incidence of pharyngocutaneous fistulae. It is also associated with better satisfaction after TL due to cosmetic benefits.

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Macarenco, Ricardo Silvestre, Carlos E. Bacchi, and Maria Aparecida Custódio Domingues. "Solitary fibrous tumor with atypical histological features occurring in the palatine tonsil: an uncommon neoplasm in an uncommon site." Journal of Oral Pathology and Medicine 35, no. 10 (November 2006): 602–5. http://dx.doi.org/10.1111/j.1600-0714.2006.00460.x.

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Mazziotti, Silvio, Ignazio Pandolfo, Tommaso D'Angelo, Achille Mileto, Carmela Visalli, Santi Racchiusa, Alfredo Blandino, and Giorgio Ascenti. "Diagnostic Approach to Retromolar Trigone Cancer by Multiplanar Computed Tomography Reconstructions." Canadian Association of Radiologists Journal 65, no. 4 (November 2014): 335–44. http://dx.doi.org/10.1016/j.carj.2014.04.001.

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Neoplasms of retromolar trigone have important peculiarities due to their spatial relationships with the surrounding structures. Tumours that involve this area can extend to nearby muscles; adipose spaces; and other anatomic structures, such as the soft palate, the tonsillar fossa, the parapharyngeal space, and the floor of the mouth. In spite of a relatively quick diagnosis, the real extent of these tumours is typically underestimated at clinical examination. Our purpose was to propose a systematic approach to the use of multiplanar computed tomography reconstructions to evaluate normal retromolar trigone anatomy and the main pathways of spread for tumours that arise in this area. To our knowledge, only few reports exist in literature about this topic and none are about the usefulness of multidetector computed tomography and multiplanar reconstructions.

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Pauloski, Barbara Roa, Jerilyn A. Logemann, Laura A. Colangelo, David Stein, Quinter Beery, Mary Anne Heiser, and Salvatore Cardinale. "Effect of Intraoral Prostheses on Swallowing Function in Postsurgical Oral and Oropharyngeal Cancer Patients." American Journal of Speech-Language Pathology 5, no. 3 (August 1996): 31–46. http://dx.doi.org/10.1044/1058-0360.0503.31.

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This study investigated the effect of intraoral-prostheses on swallowing function in 13 postsurgical oral and oropharyngeal cancer patients. Three subjects had resections of the soft palate with no involvement of the tongue. Ten subjects had resections of the posterior oral cavity or oropharynx including resection of the oral tongue, tongue base, soft palate, tonsil, and/or mandible. Patients received either an obturator only, a maxillary reshaping/lowering prosthesis, or an obturator combined with a maxillary reshaping/lowering prosthesis. Swallowing was examined with and without the prosthesis 3 months posthealing using videofluoroscopy; results are presented in the form of case reports. The majority of patients had either unchanged swallowing function or mixed results (i.e., improvement for some but not all bolus consistencies) when using an intraoral prosthesis. The extent of surgical resection, type of reconstruction, and postoperative radiotherapy had an impact on the type of prosthesis constructed and the patient’s ultimate swallowing ability. Despite the swallowing dysfunction demonstrated by some of the patients, all were able to maintain oral intake either with or without the prosthesis in place.

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Gorphe, Philippe, Stéphane Temam, Antoine Moya-Plana, Nicolas Leymarie, Frédéric Kolb, Apolline Bout-Roumazeilles, Quentin Qassemyar, Nadia Benmoussa, and Jean-François Honart. "Indications and Clinical Outcomes of Transoral Robotic Surgery and Free Flap Reconstruction." Cancers 13, no. 11 (June 6, 2021): 2831. http://dx.doi.org/10.3390/cancers13112831.

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We reviewed the indications, peroperative feasibility, and postoperative clinical outcomes of our first 50 consecutive patients who underwent free flap reconstruction after TORS for complex pharyngeal defects at our institution. We analyzed indications according to previous radiotherapy, the size of the resection, and the transoral exposure of critical structures. We reviewed surgical data, postoperative complications, and functional outcomes comprising tracheostomy and alimentation management. Indications were upfront surgery (34%), a second primary surgery after radiotherapy (28%), or salvage surgery after chemoradiotherapy failure (38%). Localizations were the tongue base (44%), tonsillar fossa (28%), pharyngeal wall (22%), and soft palate (6%). T-classifications were T1 (6%), T2 (52%), T3 (20%), and T4 (22%). The mean length of the surgery was 574 min. Two patients were intraoperatively converted to a conventional approach at the beginning of the learning curve. In conclusion, TORS and free flap reconstruction in complex situations were associated with low rates of postoperative complications and satisfactory functional outcomes. They were, however, associated with a renewed learning curve.

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Wong, Wai-Lup, Daren Gibson, Bal Sanghera, Kate Goodchild, and Michele Saunders. "Evaluation of normal FDG uptake in palatine tonsil and its potential value for detecting occult head and neck cancers: A PET CT study." Nuclear Medicine Communications 28, no. 9 (September 2007): 675–80. http://dx.doi.org/10.1097/mnm.0b013e32829152b1.

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Satyanarayana, U. "Vascular ultrastructure of head and neck tumors." Proceedings, annual meeting, Electron Microscopy Society of America 48, no. 3 (August 12, 1990): 220–21. http://dx.doi.org/10.1017/s0424820100158649.

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The Immune System protects the body against cancer either by killing the tumor cells directly or indirectly by causing damage to the tumor vasculature. Correlative Light Microscopy (LM), Scanning Electron Microscopy (SEM)and Transmission Electron Microscopy(TEM) have been done to evaluate the extent of degenerative changes in tumor vasculature.Seven different types of premalignant and malignant lesions including leukoplakia. Squamous cell carcinoma (SCC) of Tongue, Soft palate, Tonsil, Nasopharynx, Pyriform fossa and Verrucous carcinoma of lower lip have been processed for LM, SEM and TEM by conventional procedures.In most of the cases the following pathologic vascular changes were noted:a) Fine gap defects (figures 1,2).b) Coarse gap defects (figures 3,4,10-16).c) Endothelial hypertrophy (figures 5-7).d) widening of interendothelial spaces (figure8).e) Sub-adventitial edema (figure 9).Neither these pathologic changes in tumor vasculature nor the mechanism of their causation have been reported previously.

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Delagranda, Antoine, Romain Ferreira, Xavier Dufour, Maria Poisson, and Gaelle Leterme. "Sublocations of cancers of the oral cavity, oropharynx, hypopharynx, larynx, primary lymph node and other epidemiological features in a French Tropical Island in the Indian Ocean 2009-2013." International Journal of Otorhinolaryngology and Head and Neck Surgery 4, no. 3 (April 26, 2018): 618. http://dx.doi.org/10.18203/issn.2454-5929.ijohns20181852.

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Background: This study had two objectives: firstly, to describe and compare sublocations of all cancer of the oral cavity, oropharynx, hypopharynx, larynx and primary carcinoma cervical lymph node diagnosed in Reunion Island, a tropical French overseas territory in the southern hemisphere between 2009 to 2013; and secondly others epidemiological features.Methods: A retrospective study included 621 patients diagnosed with cancer of the oral cavity, oropharynx, hypopharynx or larynx or primary cervical node between 2009 and 2013 in Reunion Island. 13 possible sublocations of cancer for mouth are described, 14 for larynx, 12 for oropharynx, 3 for hypopharynx, 8 for primary cervical lymph node. Demographic characteristics, data on alcohol consumption, smoking habits, HPV infection, denutrition were analyzed. Results: Cancer location consisted of oropharynx (36.2%), larynx (25.6%), oral cavity (20.8%), hypopharynx (13.8%), primary carcinoma lymph node (3.6%). Sublocations in oral cavity mainly concerned palatin tonsil and base tongue. Vocal fold was the mostly frequent sublocation involved in larynx. Cancer in oral cavity were portion out more homogeneously. Excluding primary lymph node, sex ratio was 7.7 and mean age was 60 years. Cancer consisted of squamous cell carcinoma in 99.1% of patients. 340/375 patients (81.25%) showed alcohol abuse; 309/359 (86.1%) were smokers; 31/184 (16.8%) had HPV infection.Conclusions: First study including all cases of pharyngolarynx and oral cavity cancer and depicting all sublocations involved in one series. We found no significant difference of distribution between sublocations for larynx but some for oropharynx and oral cavity compared to literature.

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Gunn, Gary Brandon, Clifton David Fuller, Adam S. Garden, Steven J. Frank, William H. Morrison, Beth Michelle Beadle, Jack Phan, et al. "Patient-reported symptoms following IMRT alone for oropharynx cancer: A survivorship study." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): 5561. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.5561.

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5561 Background: Patients (pts) with favorable oropharynx cancer (OPC) are often treated with single modality RT with excellent disease control. We present the pattern of pt-reported symptoms in OPC survivors treated with IMRT alone. This will represent a benchmark for later comparison to pts treated with other modalities (e.g., proton therapy, transoral surgery). Methods: Pts eligible for this cross-sectional questionnaire-based study had OPC treated with IMRT (no systemic therapy), in remission >18 mos, completed the MD Anderson Symptom Inventory – Head and Neck Module (MDASI-HN). Clinical data were tabulated and analyzed using non-parametric statistics. Results: 89 pts participated. OPC sub-site was tonsil in 58, base of tongue (BOT) in 30, and soft palate in 1 pt. 65% were TX/1, 28% T2, and 7% T3/4, while 53% were NX/1 with 47% N2. Mean RT dose was 66 Gy (SD±2.5). Median age was 54 years (SD±11). Mean follow-up at MDASI-HN was 74 months (SD±15). Mean MDASI-HN symptom rating (0 to 10 scale) was 1.3 (95% CI 0.97-1.6), with no significant difference by OPC sub-site. No single MDASI-HN items showed significant difference in the percentage of pts with moderate to severe (M/S) reports by OPC site, thou dry mouth approached significance (p=0.054), 53% in BOT vs. 32% for tonsil. Overall, 14% of pts were entirely symptom free (i.e. “0” across all 22 symptom items), 33% reported only mild symptoms, 23% only moderate symptoms, and 31% reported any symptom as severe . The top 7 symptoms were dry mouth, swallowing, sleep, taste, fatigue, distress, and teeth and these were reported at M/S levels by 39%, 24%, 19%, 17%, 16%, 14%, and 10% of pts, respectively. For those with any M/S symptom, the median number of symptoms reported at M/S levels was 3. 1/89 pts had a feeding tube at the time of MDASI-HN completion. Conclusions: The late symptom burden for long-term OPC survivors following IMRT alone was low, with nearly half of pts with only minimal symptoms across all items. Considering other endpoints (e.g. disease control, acute toxicity, second malignancies, and functional measures), future treatment strategies should seek to match or exceed these results. Future RT symptom prevention/reduction strategies should focus on the top symptoms identified here.

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Karpenko, A. V., R. R. Sibgatullin, A. A. Boyko, N. S. Chumanikhina, E. Yu Lomteva, M. V. Lavrova, M. G. Kostova, and O. M. Nikolayeva. "Surgery for advanced oropharyngeal cancer." Head and neck tumors (HNT) 8, no. 3 (November 8, 2018): 37–45. http://dx.doi.org/10.17650/2222-1468-2018-8-3-37-45.

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The study objectiveis to assess the results of this approach and identifications of factors that may influence the effectiveness of such an approach.Materials and methods. Since 2009 through 2016 72 patients with stage III and IV aged between 42 and 77 years underwent upfront surgery.Anatomical sites included 34 (46 %) tonsil, 24 (33 %) base of tongue and 14 (21 %) soft palate cases. Transcervical sparing the mandible,mandibulectomy and transoral approaches were used in 42 (58 %), 11 (15 %) and 7 (10 %) patient, respectively. Total glossectomy was performed in 4 (5.5 %) cases. Tumor extension necessitated extended laryngectomy in 8 patients (11.5 %). Primary closure of the pharyngeal wound was possible in 30 patients (42 %). Reconstruction with distant flaps was performed in the remaining 42 patients. Both free (anterolateral thigh – 19, radial forearm flap – 10) and flaps with axial blood supply (pectoralis major – 9, supraclavicular flap – 4) were used. There were 6 T1, 12 T2, 28 T3 and 20 T4 tumors; 62 patients were N-positive: N1 – 10 cases, N2 – 51, N3 – 1. Positive surgical margins were diagnosed in 13 cases (18 %) including 3 cases of R2 resection. Adjuvant radiation therapy with or without chemotherapy was completed in 45 patients (63.4 %). Survival was calculated according to Kaplan–Mayer method.Results.There was 1 death in early postoperative period. Mean follow-up for the remaining patients (n = 71) was 27 months (1–94). Median survival was 27 months (95 % CI 11.5–42.5); 3-year overall survival was 44 %; 33 out of 34 still alive patients are capable to take food orally. Only 1 (2.9 %) patient is gastrostomy tube dependent. Univariate analysis revealed that positive margins (p <0.0001) and completeness of combined treatment (p <0.01) are the main factors that have statistically significan impact on prognosis.Conclusion.Combined approach with upfront surgery is one of the main treatment modalities for advanced oropharyngeal cancer. Modern reconstructive options and strict adherence to a proper surgical technique give a high chance for a valuable rehabilitation for the vast majority of patients. Scrupulous planning of the resection of the primary tumor based on modern imaging techniques and encouraging patients to complete all prescribed treatments are the main physician-related factors that influence survival outcome.

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Nichols, Anthony Charles, Julie Theurer, Eitan Prisman, Nancy E. Read, Eric Berthelet, Eric Tran, Fung Kevin, et al. "A phase II randomized trial for early-stage squamous cell carcinoma of the oropharynx: Radiotherapy versus trans-oral robotic surgery (ORATOR)." Journal of Clinical Oncology 37, no. 15_suppl (May 20, 2019): 6006. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.6006.

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6006 Background: The incidence of OPSCC has risen rapidly, due to an epidemic of human papillomavirus (HPV) infection. Radiation therapy (RT) has historically been the standard treatment, but transoral robotic surgery (TORS) has surpassed RT in the US as the most common approach, based on assumptions of reduced toxicity or improved quality of life (QOL). No randomized trials have previously compared these treatments. Methods: The ORATOR trial (NCT01590355) enrolled patients with T1-T2 N0-2(≤4 cm) OPSCC amenable to TORS. We randomly assigned patients, stratified by p16 status, to RT (70 Gy/35 fractions, with chemotherapy if N1-2) vs. TORS (± adjuvant [chemo]RT based on pathology). The primary endpoint was a definitive comparison of swallowing QOL at 1-year using the MD Anderson Dysphagia Inventory (MDADI), powered to detect a 10-point improvement (a clinically-meaningful change [CMC]) in the TORS arm. Secondary endpoints included adverse events (AEs), other QOL outcomes [including EORTC scales, the Voice Handicap Index-10, Neck Dissection Impairment Index, and Patient Neurotoxicity Questionnaire], overall- and progression-free survival (OS, PFS). All analyses were pre-specified and intention-to-treat. Results: Between 2012 and 2017, 68 patients were randomized (n = 34 in each arm), in Canada and Australia. Median age was 59 years; 87% were male. Primary tumor sites were palatine tonsil (74%) or base of tongue (26%). Arms were well-balanced for baseline factors, including p16 status (88% in each arm). Median follow-up was 27 months. MDADI scores at 1-year were statistically superior in the RT arm (mean ± SD: 86.9 ± 11.4 vs. 80.1 ± 13.0 in the TORS arm; p = 0.042), but not meeting the definition of a CMC. For the other QOL metrics, outcomes were similar at 1-year. Feeding tube rates at 1-year were 3% (n = 1) vs. 0% respectively. Rates of treatment-related grade ≥2 AEs were similar (91% vs. 100%, p = 0.24), with more neutropenia, constipation and tinnitus in the RT arm and more trismus in the TORS arm (all p < 0.05). There was one TORS bleeding-related death. OS and PFS were similar. Conclusions: RT had superior swallowing QOL scores at 1 year compared to TORS, but the difference was not a CMC. Toxicities differed between the arms. This study provides the first level 1 evidence to inform patients of the QOL impact of both approaches. Clinical trial information: NCT01590355.

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Inukai, Daisuke, Taichi Kan, Shunpei Yamanaka, Hiroki Okamoto, Yasushi Fujimoto, Takanori Ito, Natsuki Taniguchi, et al. "Pathological and Virological Studies of p16-Positive Oropharyngeal Carcinoma with a Good Response to Neoadjuvant Chemotherapy." Microorganisms 8, no. 10 (September 29, 2020): 1497. http://dx.doi.org/10.3390/microorganisms8101497.

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Human papillomavirus (HPV)-related, p16-positive oropharyngeal carcinoma is considered to be sensitive to anticancer drugs, and the standard treatment is therefore chemoradiotherapy, rather than surgery, especially for aggressive disease. However, with this higher sensitivity, chemotherapy alone may achieve a pathological complete response (CR), making radiation therapy unnecessary. A 46-year-old man with p16-positive squamous cell carcinoma (SCC) of the lateral oropharynx (palatine tonsil) underwent neoadjuvant chemotherapy. This achieved clinically significant tumor shrinkage and therefore surgery was performed for subsequent definitive treatment. Clinical and CT findings indicated a good effect of neoadjuvant chemotherapy on the tumor. A biopsy prior to chemotherapy revealed SCC, which demonstrated p16 immunoreactivity and positive signals for high-risk HPV by RNA in situ hybridization. The post-chemotherapy surgical specimen showed pathological CR and no p16 positive cells nor positive signals for high-risk HPV those were detected in the pre-chemotherapy specimen. There are some reports of chemotherapy alone achieving pathological CR in cases of p16-positive oropharyngeal carcinoma, but none have included high-risk HPV RNA findings. This is the first report of the disappearance of cancer cells as well as p16 staining and a positive signal for high-risk HPV. Achieving pathological CR confirmed by immunohistochemistry and high-risk HPV RNA in situ hybridization in a solid tumor with chemotherapy alone suggests that chemotherapy may have both an antitumor effect and an antiviral effect. Forgoing subsequent radiotherapy and undergoing surgery might be unnecessary and follow-up instead might be sufficient in such cases. Into the future, in an optimal tailored treatment approach, the option of neoadjuvant chemotherapy should be considered for management of p16-positive oropharyngeal carcinoma. Other options such as tumor immunotherapy are also expected to be effective.

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Trivedi, Sumita, Haocan Song, Yuan Liu, Conor Ernst Steuer, William Stokes, Azeem Kaka, Mihir Patel, et al. "Comparison of the seventh and eighth editions of the American Joint Committee on Cancer (AJCC) staging for oropharyngeal squamous cell carcinomas (OPSCC): A Surveillance, Epidemiology and End Results Program (SEER) database analysis." Journal of Clinical Oncology 37, no. 15_suppl (May 20, 2019): e17538-e17538. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.e17538.

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e17538 Background: The recently released eighth edition of the American Joint Committee on Cancer (AJCC) Staging Manual, Head and Neck Section, incorporates significant changes to the prior seventh edition. The changes reflect the improved understanding of tumor biology, prognostic factors and molecular markers that effect outcomes in Head and Neck cancers. A key update restages OPSCC by human papilloma virus (HPV) positive and negative cancers as data demonstrated that these tumors have significantly different biology and outcomes. Methods: Using SEER data from 2004 – 2014, we identified male patients with squamous cell carcinomas of the tonsil, base of tongue and soft palate aged between 21 and 64 years old (those clinical characterizes were considered as surrogate markers for HPV positive status). We classified them by the AJCC 8th edition staging for HPV positive OPSCC and by AJCC 7th edition staging. The prediction performance by two staging editions were compared regarding overall survival (OS) and Disease free survival (DFS). Kaplan-Meier method and Cox proportional hazard model were applied, and the discrimination performance was measured by the concordance statistics (C-statistics). Results: A total of 8202 eligible patients were included in the analysis with a median follow up period of 51 months. 7415 (90.4%) patients had previously received radiation and 7038 (85.8%) patients had previously received chemotherapy. The median age of patients was 56 years. Distribution of stage I disease increased from 2% to 19.6% in AJCC 8th edition. 10-year overall survival (OS) for AJCC 8th stages I (74%), II (78%), III (55%) and IV (32%). Using Stage I as reference, the hazard ratio for stage II, III, and IV is 0.98 (95%CI: 0.87-1.09), 2.29 (95%CI: 2.04-2.57), and 5.88 (95%CI: 4.96-6.98). Similar results were noted for ten year disease free survival. The C-statistics measured overall discrimination for 8th edition is 0.68 and 0.63 for the 7th edition (P < 0.001). Conclusions: Based on this SEER analysis, the overall performance of discrimination improved from AJCC 7th to 8th edition; but in this study population, AJCC 8th edition does not distinguish stage I and II sufficiently as expected as it does for stages III and IV disease. Limitations of the SEER database include the surrogate for P16 status and under reported and incomplete data.

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Schwartz, David L., Sara Parise, Jordan Denitz, Vinh Nguyen, John Fantasia, Bhoomi Mehrotra, Benjamin Saltman, and Douglas Frank. "A phase I dose-escalation trial of SRS boost treatment of human papilloma virus (HPV)-unassociated oropharyngeal squamous cell carcinoma (OPSCC)." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): e16026-e16026. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.e16026.

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e16026 Background: HPV-negative status and/or significant smoking history predict for poor radiation response in patients with OPSCC. To improve disease control outcomes in this population, we are conducting a phase I dose-escalation trial of stereotactic radiotherapy boost delivery to primary disease. Methods: Thirteen consecutive patients with newly diagnosed HPV-unassociated OPSCC were enrolled onto this IRB-approved clinical trial between 5/2010 and 10/2011. Eligible patients had HPV-negative disease and/or tobacco exposure history of >10 pack-years. The cohort consisted of 12 males/1 female with a median age of 58.5 yrs (range: 46-64). There were 9 tonsil/2 tongue base/1 soft palate/1 GP sulcus cases, with 5 T2/5 T3/3 T4 primaries and 2 AJCC stage III/11 stage IV disease. Primary disease received 60 Gy, gross nodal disease 66 Gy, and prophylactic nodal target volumes 54-60 Gy with routine IMRT technique in 30 daily fractions. All patients received concurrent chemotherapy (12 cisplatinum-based, 1 cetuximab). Within one week of IMRT completion, SRS boost treatment was delivered to the primary disease target volume. Initial SRS dose level was set at 8 Gy, and has been delivered to 11 enrolled patients, with 1 patient pending and 1 patient self-removed from protocol. Median follow up for completed patients is 11 (range: 5-17) months. Results: Twelve cases are evaluable. Post-SRS boost adverse events have remained limited mostly to Gr 2-3 xerostomia, pain, and dysphagia. Five patients have required PEG placement. No acute or chronic Gr 4-5 toxicity has been observed. One patient with bulky T4 disease died of persistent disease. One patient with residual adenopathy had consolidative neck dissection and remains free of disease, as do the remaining 10 patients who responded completely. Conclusions: 8 Gy SRS boost treatment to high-risk primary OPSCC disease is feasible and safe, and step-wise dose escalation is ongoing.

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Chaturvedi, A., E. Engels, W. Anderson, and M. Gillison. "Incidence trends for human papillomavirus-related (HPV-R) and unrelated (HPV-U) head and neck squamous cell carcinomas (HNSCC) in the United States (US)." Journal of Clinical Oncology 25, no. 18_suppl (June 20, 2007): 6001. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.6001.

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6001 Background: HNSCC are etiologically heterogeneous, with one subset primarily attributable to HPV and another to tobacco and alcohol. Methods: Data from SEER9 program registries were used to investigate the potential influence of HPV on incidence and survival of HNSCC in the US from 1973–2003. HNSCCs (N=58,158) were classified by anatomic site as potentially HPV-R (base of tongue; tonsil; oropharynx; N=16,712) or HPV-U (lip; tongue; gum; floor of mouth; palate; other mouth; hypopharynx; ill-defined sites of lip, oral cavity, and pharynx; N=41,446). Joinpoint regression was used to assess incidence trends and life-table methods were used to compare survival for HPV-R and HPV-U HNSCCs. Results: For HPV-R HNSCCs, age-adjusted incidence increased significantly from 1973–2003 (annual percent change [APC] = 0.65), particularly among males (APC=1.02), whites (APC=0.89), and younger ages (APCs for 30–39 = 1.46; 40- 49=1.92; 50–59=0.61, and =60= -0.66). By contrast, HPV-U HNSCC incidence was stable from 1973–1983 and then decreased significantly from 1983–2003 (APC= -2.42). Mean age at diagnosis was younger for HPV-R HNSCC than HPV-U (61.1 vs. 64.5 years; p<0.001), and from 1973- 2003, decreased significantly for HPV-R, but increased for HPV-U. Improvements in overall survival (OS) were observed for HPV-R (all stages) and HPV-U (regional and distant) HNSCC treated by radiotherapy (RT) from 1973–2003, but were more marked for HPV-R HNSCC, e.g. absolute increase in two-year OS for regional disease of 24.4% (vs. 5.8% for HPV-U). OS for HPV-R (local and regional) was significantly better than HPV-U HNSCC if treated by RT, but worse if not so treated. Conclusions: The proportion of HNSCC that is potentially HPV- R increased in the US from 1973–2003, particularly among recent birth cohorts, perhaps due to changing sexual and smoking behaviors. Recent improvements in locoregional control with RT-based therapy may be due in part to a gradual shift in the etiology of the underlying disease. No significant financial relationships to disclose.

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Economides, Minas P., Erich M. Sturgis, Moran Amit, Jeff Hosry, Parag Mahale, Ying Jiang, and Harrys A. Torres. "The impact of chronic hepatitis C virus infection on survival in oropharyngeal cancer patients." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): e17556-e17556. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.e17556.

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e17556 Background: An association between Hepatitis C virus (HCV) infection and oropharyngeal cancers (OPCs) has been reported; however, the clinical significance of this epidemiological finding remains unknown. We therefore analyzed the oncologic outcomes of HCV-infected patients (pts) with OPCs. Methods: In this retrospective cohort study, all pts with OPCs seen at MD Anderson (1/2004-12/2015) were reviewed. HCV infection was defined as detectable HCV RNA in serum. Risk of 5-year (yr) overall survival (OS) and progression-free survival (PFS) was compared between HCV-infected (HCV+) and uninfected (HCV-) pts. OPCs that were positive for p16 by immunohistochemistry were considered HPV-related. Antiviral therapy (AVT) included either interferon (IFN)-based or IFN-free regimens. Multivariate cox proportional hazards model was used to identify independent predictors of mortality. Results: We studied 161 pts. Most of the pts were white (141; 88%), male (132; 82%) and had tumor stage 3 or 4 (147; 92%). The OPC involved tonsils (83; 52%), base of tongue (67; 42%) or soft palate (11; 7%). The median follow-up time after OPC diagnosis was 3 yrs (range: 1-13 yrs). HCV+ (n = 25) and HCV- pts (n = 136) were comparable in regards to smoking and alcohol status. In univariate analysis, HCV+ pts had more OPC progression after 1stline cancer treatment (48% vs 20.6% in HCV-, P = .0009) and were more likely to relapse (26% vs 5% in HCV-, P = .02). In multivariate analysis, HCV was associated with increased all-cause mortality [hazard ratio (HR): 2.15, 95% confidence intervals (CI): 1.08-6.85; P = .02] and risk of OPC progression [HR: 5.42, 95% CI: 2.64-11.14; P = .0008] independent of age and cirrhosis status. In HPV+ OPCs (n = 86), HCV + and HCV- pts did not have significant difference in mortality [HR: 2.03, 95% CI: 0.82-4.98; P = .12]. AVT was administered after OPC diagnosis in 8 of the 25 HCV+ pts (32%), with 6 of them receiving IFN-free AVT. HCV+ pts that received AVT had better 5 yr OS (median of 5.2 vs 2.3 yrs, P = .005) and PFS (median of 3.1 vs 0.7 yrs, P = .007) than the ones who did not. Conclusions: HCV seems to affect the oncologic outcomes of pts with OPCs and treating this infection might be beneficial. HCV screening and treatment should be considered in such pts.

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Kantharia, Rajesh A., Roopa Ganta, Shehnaz R. Kantharia, and Bhavin Bhupendra Shah. "Image guided biopsy/FNAC in head and neck cancers in covid 19 pandemic." IP Indian Journal of Anatomy and Surgery of Head, Neck and Brain 7, no. 2 (August 15, 2021): 51–53. http://dx.doi.org/10.18231/j.ijashnb.2021.011.

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Suspected growth in the region of base of tongue, pharynx, and larynx need direct/indirect laryngoscopy for establishing Diagnosis and for Staging of the disease. The Covid 19 Pandemic has severely affected these modes of examination because they are Aerosol Generating Procedures and carry very high risk of transmission of the Virus. The Department of Head And Neck Oncosurgery at KCHRC is one of the busiest department at our Institute with an average annual footfall of around 20,000 new patients. The main objective of our study is to know the role of Image Guided Biopsy/FNAC for primary diagnosis in Head and Neck Cancers. Retrospective analysis of prospectively collected data of 35 patients was done from April to September 2020. Histopathological records along with patient’s clinical records were reviewed. Of the 35 patients, 23 patients underwent CT Guided biopsies, 11 patients had CT Guided FNA and one patient had USG guided biopsy. In 23 patients (CT Guided Biopsy), the biopsy was taken from tongue in 16 patients, Larynx in two patient, Pyriform sinus(PFS), posterior pharyngeal wall, RMT (retromolar trigone), lower GBS and Tonsil sites had one patient each. Of the 11 CT Guided FNAC patients, the site of FNA was from PFS in 7 patients, Tongue in 2 patients RMT and soft palate had one patient each. One patient had undergone USG Guided biopsy for PFS lesion. Out of 35 patients, tissue specimen taken was adequate in 33 patients and inadequate in two patients. The results were supported both histologically and clinically. The histological confirmation was found in 88.6% cases (31/35), squamous cell carcinoma was found in 74.3% cases (26/35), no malignancy in 8.5% cases(3/35), no specific lesion in 5.7% cases(2/35), no definitive diagnosis in 2.8% cases(1/35) and in inadequate in 8.5% cases(3/35). Repeat biopsy in one patient revealed no malignancy. There were no post procedure complications noted. Image guided biopsy/FNAC is a safe, reliable minimally invasive technique and can be used for primary diagnosis of Head and Neck cancers without the risk of Aerosol generation in the current Covid -19 Pandemic.

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Borges, Natália Morais, Marina Lourenço de Conti, Tathiana Azevedo de Andrade, Marina Petaccia Macedo, Maria Dirlei Ferreira de Souza Begnami, Antônio Corrêa Alves, and Gisele Wally Braga Colleoni. "Pro-Angiogenic Mir-296 Is Frequently Overexpressed and Is Associated with Advanced Stage Disease in Diffuse Large B-Cell Lymphoma." Blood 120, no. 21 (November 16, 2012): 1570. http://dx.doi.org/10.1182/blood.v120.21.1570.1570.

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Abstract Abstract 1570 Introduction: MicroRNAs (miRNAs) are a class of endogenous short non-coding RNAs that control gene expression by acting on target mRNAs for promoting either their degradation or translational repression. Some of them have involvement in regulating various aspects of angiogenesis, including proliferation, migration and morphogenesis of endothelial cells, which are important in regulating cardiovascular development and cancer. The term “angiomiR” is used to define the miRNAs that control angiogenesis. They are classified into pro-angiomiRs, those that promote angiogenesis, and anti-angiomiRs, those that inhibit angiogenesis. The identification of angiomiRs as the key to regulating angiogenesis has opened new paths in the treatment of vascular and oncology diseases. Aims: This study aims to analyze the expression angiomiRs in diffuse large B-cell lymphoma (DLBCL) and to correlate them with clinical and histological features to identify possible biomarkers and prognostic factors. Patients and Methods: We studied 93 samples of de novo DLBCL diagnosed between 2000 and 2010. All the cases were HIV-negative. MicroRNAs were obtained from paraffin embedded tumor samples using RecoverAll™ Total Nucleic Acid Isolation Kit for FFPE Tissues (Applied Biosystems). Four angiomiRs (miR-378, miR-296, miR-210 and miR-126) were analyzed. RNU44 and U18 were used as endogenous controls for quantitative PCR (TaqMan®Small RNA Assays). We set a threshold of a 1.5-fold difference in angiomiRs expression compared to controls (palatine tonsil). Results: miR-378, miR-296, miR-210 and miR-126 overexpression were observed in 43%, 47%, 22% and 5%, respectively. Considering that miR-378 and miR-296 were frequently overexpressed in DLBCL, we further analyzed the following variables: age (<=60 versus >60 years), Ann Arbor Staging System (I-II versus III-IV), International Prognostic Index (0–2 versus 3–5), DLBCL classification (NOS versus subtypes), tumor origin according to Hans (2004) algorithm (GCB versus non-GCB). We observed higher median miR-296 expression in DLBCL classified as stage III-IV (p = 0.0415, Mann-Whitney). For the other variables, were did not find any statistically significant difference between groups. Conclusions: miR-296, that directly decreased the levels of hepatocyte-growth factor regulated tyrosine kinase substrate (HGS) and indirectly upregulate VEGFR2 and PDGFRβ, was overexpressed in almost 50% of de novo DLBCL and was associated with advanced stage disease. Our study brings new information about the role of microRNA importance in DLBCL development and can be explored as prognostic and therapeutic target for patients suffering from this prevalent malignancy (Supported by FAPESP 2010/17668-6). Disclosures: No relevant conflicts of interest to declare.

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Lee, Jeong Hoon, Eun Ju Ha, Jin Roh, Su Jin Lee, and Jeon Yeob Jang. "Technical feasibility of radiomics signature analyses for improving detection of occult tonsillar cancer." Scientific Reports 11, no. 1 (January 8, 2021). http://dx.doi.org/10.1038/s41598-020-80597-3.

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AbstractDiagnosis of occult palatine tonsil squamous cell carcinoma (SCC) using conventional magnetic resonance imaging (MRI) is difficult in patients with cervical nodal metastasis from an unknown primary site at presentation. We aimed to establish a radiomics approach based on MRI features extracted from the volume of interest in these patients. An Elastic Net model was developed to differentiate between normal palatine tonsils and occult palatine tonsil SCC. The diagnostic performances of the model with radiomics features extracted from T1-weighted image (WI), T2WI, contrast-enhanced T1WI, and an apparent diffusion coefficient (ADC) map had area under the receiver operating characteristic (AUROC) curve values of 0.831, 0.840, 0.781, and 0.807, respectively, for differential diagnosis. The model with features from the ADC alone showed the highest sensitivity of 90.0%, while the model with features from T1WI + T2WI + contrast-enhanced T1WI showed the highest AUROC of 0.853. The added sensitivity of the radiomics feature analysis were 34.6% over that of conventional MRI to detect occult palatine tonsil SCC. Therefore, we concluded that adding radiomics feature analysis to MRI may improve the detection sensitivity for occult palatine tonsil SCC in patients with a cervical nodal metastasis from cancer of an unknown primary site.

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Lee, Jeong Hoon, Eun Ju Ha, Jin Roh, Su Jin Lee, and Jeon Yeob Jang. "Technical feasibility of radiomics signature analyses for improving detection of occult tonsillar cancer." Scientific Reports 11, no. 1 (January 8, 2021). http://dx.doi.org/10.1038/s41598-020-80597-3.

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AbstractDiagnosis of occult palatine tonsil squamous cell carcinoma (SCC) using conventional magnetic resonance imaging (MRI) is difficult in patients with cervical nodal metastasis from an unknown primary site at presentation. We aimed to establish a radiomics approach based on MRI features extracted from the volume of interest in these patients. An Elastic Net model was developed to differentiate between normal palatine tonsils and occult palatine tonsil SCC. The diagnostic performances of the model with radiomics features extracted from T1-weighted image (WI), T2WI, contrast-enhanced T1WI, and an apparent diffusion coefficient (ADC) map had area under the receiver operating characteristic (AUROC) curve values of 0.831, 0.840, 0.781, and 0.807, respectively, for differential diagnosis. The model with features from the ADC alone showed the highest sensitivity of 90.0%, while the model with features from T1WI + T2WI + contrast-enhanced T1WI showed the highest AUROC of 0.853. The added sensitivity of the radiomics feature analysis were 34.6% over that of conventional MRI to detect occult palatine tonsil SCC. Therefore, we concluded that adding radiomics feature analysis to MRI may improve the detection sensitivity for occult palatine tonsil SCC in patients with a cervical nodal metastasis from cancer of an unknown primary site.

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Huang, Yen-Jung, Chih-Tien Chen, Yao-Wen Hsieh, and Shang-Heng Wu. "Rectal Cancer With Synchronous Tonsillar Metastasis: A Case Report and Literature Review." Ear, Nose & Throat Journal, November 9, 2020, 014556132097192. http://dx.doi.org/10.1177/0145561320971928.

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Colorectal cancer is the third most common cancer globally and nearly one fourth of distant metastases are found at the time of the primary diagnosis. Synchronous metastasis of colorectal cancer to the palatine tonsil is rare. To date, only 5 cases have been published in the English literature. In such cases, the prognosis is worse than in other common metastatic sites. Herein, we report a case of rectal adenocarcinoma who presented with a tonsillar mass initially.

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Journal articles on the topic 'Tonsille palatine – Cancer'

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