1,046 results on '"Tonsillar Neoplasms pathology"'
Search Results
52. Lacrimal sac primary squamous cell carcinoma with synchronous tonsillar primary squamous cell carcinoma.
- Author
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Lin Z, Philpott C, Sisson K, and Hemmant B
- Subjects
- Carcinoma, Squamous Cell diagnostic imaging, Carcinoma, Squamous Cell surgery, Eye Neoplasms diagnostic imaging, Eye Neoplasms surgery, Humans, Lacrimal Apparatus Diseases diagnostic imaging, Lacrimal Apparatus Diseases surgery, Lymph Nodes pathology, Lymphatic Metastasis, Male, Middle Aged, Natural Orifice Endoscopic Surgery, Neoplasms, Multiple Primary diagnostic imaging, Neoplasms, Multiple Primary surgery, Positron Emission Tomography Computed Tomography, Tomography, X-Ray Computed, Tonsillar Neoplasms diagnostic imaging, Tonsillar Neoplasms surgery, Carcinoma, Squamous Cell pathology, Eye Neoplasms pathology, Lacrimal Apparatus Diseases pathology, Neoplasms, Multiple Primary pathology, Tonsillar Neoplasms pathology
- Abstract
A gentleman with recurrent epiphora after two failed endonasal dacryocystorhinostomies was found to have a squamous cell carcinoma of the lacrimal sac at his third operation via an external approach. CT showed contralateral nodal involvement; however, biopsy of the node found it to be histologically distinct from the lacrimal sac lesion. A PET-CT revealed a second primary lesion located at the contralateral palatine tonsil. We discuss the histological features of squamous cell carcinomas and the impact on prognosis. This case highlights the importance of nasoendoscopy prior to lacrimal surgery. There should be a low threshold for lacrimal sac biopsy, and any anatomical or histological inconsistency should prompt further investigation.
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- 2020
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53. High-risk human papillomavirus-mediated adenocarcinoma of palatine tonsil.
- Author
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Alexiev BA, Behdad A, Lu X, Cheng E, and Samant S
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- Adenocarcinoma genetics, Adenocarcinoma pathology, Biomarkers, Tumor analysis, Humans, Male, Middle Aged, Tonsillar Neoplasms genetics, Tonsillar Neoplasms pathology, Adenocarcinoma virology, Papillomavirus Infections complications, Tonsillar Neoplasms virology
- Abstract
We describe the case of a human papillomavirus-mediated adenocarcinoma of palatine tonsil in a 51-year-old male. Histologically, the tumor exhibited a predominantly cribriform and tubular (glandular) growth of cuboidal and columnar cells with moderate amount of pale eosinophilic cytoplasm and oval or spindled nuclei with finely dispersed or coarse chromatin and small to medium-sized nucleoli. Foci of nuclear anaplasia and multinucleation, numerous mitotic figures, and necrosis (individual-cell and confluent) were seen. No squamous differentiation was identified. The tumor cells showed strong expression of CK7, p16 and HPV E6/E7 mRNA transcripts, and were negative for p40, CK5/6, AR, synaptophysin and chromogranin. Next generation sequencing showed 3 variants of unknown significance: FGF3 p.(R44fs); NF1 p.(S749 L) and POLE p. (S1506 L) with variant allele frequencies of 37 %; 20 %, and 17 % respectively. Chromosomal microarray analysis using single nucleotide polymorphism microarray (OncoScan) assay showed whole chromosomal gains of chromosomes 8 and 19, whole chromosomal losses of chromosomes 2 and 16, as well as segmental gains of chromosomes 3q25.31q29 (encompassing the PIK3CA gene), 17q21.31q25.3, 20p13q13.33, Xq28, and segmental losses of chromosomes 1q32.2, 6p25.1p21.1, 11q23.1q24.1, 12p11.22, 12p11.22, 14q24.1q32.33, 17p13.3q21.31 (encompassing the TP53 and NF1 genes). The results highlight the need to consider HPV testing in non-squamous cell carcinomas of the oropharynx., Competing Interests: Declaration of Competing of Interest We declare that we have no relevant conflict of interest., (Copyright © 2020 Elsevier GmbH. All rights reserved.)
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- 2020
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54. Synchronous thoracic and head-and-neck malignancies-double trouble-challenges, pitfalls, and lessons learnt.
- Author
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Sood KS, Himthani M, Tanwar A, and Perumal SL
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- Breast Neoplasms radiotherapy, Esophageal Neoplasms radiotherapy, Female, Humans, Male, Neoplasms, Multiple Primary radiotherapy, Prognosis, Tongue Neoplasms radiotherapy, Tonsillar Neoplasms radiotherapy, Breast Neoplasms pathology, Carcinoma, Squamous Cell pathology, Esophageal Neoplasms pathology, Neoplasms, Multiple Primary pathology, Tongue Neoplasms pathology, Tonsillar Neoplasms pathology
- Abstract
Synchronous malignancies arising from head and neck and thorax are rare presentation, and only few cases are reported in the scientific literature. We report three cases of double primary malignancies treated at our hospital., Competing Interests: None
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- 2020
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55. Management of the difficult airway in the COVID-19 pandemic: Illustrative complex head and neck cancer scenario.
- Author
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Rassekh CH, Jenks CM, Ochroch EA, Douglas JE, O'Malley BW Jr, and Weinstein GS
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- COVID-19, COVID-19 Testing, Carcinoma, Squamous Cell secondary, Clinical Laboratory Techniques, Coronavirus Infections diagnosis, Coronavirus Infections transmission, Humans, Male, Middle Aged, Pneumonia, Viral diagnosis, Pneumonia, Viral transmission, SARS-CoV-2, Tracheal Neoplasms secondary, Betacoronavirus, Carcinoma, Squamous Cell surgery, Coronavirus Infections prevention & control, Infectious Disease Transmission, Patient-to-Professional prevention & control, Pandemics prevention & control, Pneumonia, Viral prevention & control, Tonsillar Neoplasms pathology, Tracheal Neoplasms surgery
- Abstract
Background: This case highlights challenges in the assessment and management of the "difficult airway" patient in the SARS-CoV-2 (COVID-19) pandemic era., Methods: A 60-year-old male with history of recent transoral robotic surgery resection, free flap reconstruction, and tracheostomy for p16+ squamous cell carcinoma presented with stridor and dyspnea 1 month after decannulation. Careful planning by a multidisciplinary team allowed for appropriate staffing and personal protective equipment, preparations for emergency airway management, evaluation via nasopharyngolaryngoscopy, and COVID testing. The patient was found to be COVID negative and underwent imaging which revealed new pulmonary nodules and a tracheal lesion., Results: The patient was safely transorally intubated in the operating room. The tracheal lesion was removed endoscopically and tracheostomy was avoided., Conclusions: This case highlights the importance of careful and collaborative decision making for the management of head and neck cancer and other "difficult airway" patients during the COVID-19 epidemic., (© 2020 Wiley Periodicals, Inc.)
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- 2020
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56. Comparative cost of transoral robotic surgery and radiotherapy (IMRT) in early stage tonsil cancer.
- Author
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Spellman J, Coulter M, Kawatkar A, and Calzada G
- Subjects
- Carcinoma, Squamous Cell pathology, Cohort Studies, Humans, Markov Chains, Neoplasm Staging, Tonsillar Neoplasms pathology, Carcinoma, Squamous Cell economics, Carcinoma, Squamous Cell radiotherapy, Carcinoma, Squamous Cell surgery, Cost-Benefit Analysis, Radiotherapy, Intensity-Modulated economics, Radiotherapy, Intensity-Modulated methods, Robotic Surgical Procedures economics, Robotic Surgical Procedures methods, Tonsillar Neoplasms economics, Tonsillar Neoplasms radiotherapy, Tonsillar Neoplasms surgery
- Abstract
Purpose: To compare treatment costs and cost-effectiveness for transoral robotic surgery (TORS) and definitive intensity-modulated radiotherapy (IMRT) in managing early stage tonsil cancer., Materials and Methods: Direct treatment costs for surgery and IMRT were calculated from SEER-Medicare data for a cohort with clinically early stage (cT1/2N0) p16+ tonsillar squamous cell carcinoma from Kaiser Permanente Southern California Health Plan between 2012 and 2017. A Markov decision tree model with a 5-year time horizon was then applied to the cohort which incorporated costs associated with treatment, surveillance, and recurrence., Results: IMRT cost up to $19,000 more (35%) than TORS in direct treatment costs. When input into the Markov model, TORS dominated IMRT with lower cost and better effectiveness over a range of values., Conclusion: TORS is a more cost-effective treatment method than IMRT in early stage (cT1/2N0) tonsil cancer., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Published by Elsevier Inc.)
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- 2020
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57. Left atrial tumor thrombus with emboli to the brain and distal extremities: A case report.
- Author
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Layfield LJ, Freeman D, and Crim JR
- Subjects
- Extremities, Fatal Outcome, Humans, Male, Middle Aged, Neoplasms, Squamous Cell complications, Neoplasms, Squamous Cell pathology, Thrombosis etiology, Thrombosis pathology, Tonsillar Neoplasms complications, Tonsillar Neoplasms pathology, Heart Atria pathology, Neoplastic Cells, Circulating pathology, Stroke etiology
- Abstract
Cardiac metastases are an uncommon phenomenon associated with neoplasms from a variety of primary sites. Pulmonary involvement often accompanies metastases involving the left atrium or ventricle and clinical presentation may be associated with stroke or emboli involving distal sites. We report a patient who presented acutely to the Emergency Department with symptoms of a cerebrovascular accident and bilateral cold pulseless lower extremities. Computerized Tomographic (CT) angiogram of the chest, abdomen, pelvis and lower extremities disclosed pulmonary veins with large filling defects in the right superior and inferior vessels as well as the left atrium and atrial appendage. Mediastinal and hilar adenopathy was detected. The patient had a history of tonsillar squamous cell carcinoma eighteen months prior. The patient underwent operative intervention with removal of a large left intra-atrial mass, histologic evaluation of which demonstrated groups of malignant squamous cells meshed in fibrin clot. The patient died three days post operatively due to multiple brain infarctions., (Copyright © 2020. Published by Elsevier GmbH.)
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- 2020
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58. A metastatic histiocytic sarcoma case with primary involvement of the tonsil.
- Author
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Aytekin A, Ozet A, Bilgetekin I, Ogut B, Ciltas A, and Benekli M
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- Adrenal Gland Neoplasms diagnostic imaging, Adrenal Gland Neoplasms therapy, Combined Modality Therapy, Fluorodeoxyglucose F18, Histiocytic Sarcoma diagnostic imaging, Histiocytic Sarcoma therapy, Humans, Liver Neoplasms diagnostic imaging, Liver Neoplasms therapy, Lymphatic Metastasis, Male, Middle Aged, Positron Emission Tomography Computed Tomography methods, Prognosis, Radiopharmaceuticals, Tonsillar Neoplasms diagnostic imaging, Tonsillar Neoplasms therapy, Adrenal Gland Neoplasms secondary, Histiocytic Sarcoma pathology, Liver Neoplasms secondary, Tonsillar Neoplasms pathology
- Abstract
Histiocytic sarcoma (HS) is an extremely rare and aggressive hematopoietic tumor. Although it can be seen at any anatomic location, the most common primary sites are skin as extranodal region, locations including the lymph nodes and gastrointestinal tract. To the best of our knowledge, in light of PubMed search, this is the first primary tonsillar HS case presented with disseminated metastases at the time of diagnosis. A 58-year-old male patient applied with swelling on the right side of the neck, difficulty in swallowing, and weight loss. Positron emission tomography computed tomography was performed and increased pathological 18F fluorodeoxy D glucose uptake was detected in the right palatine tonsil, bilateral cervical multiple lymph nodes, liver masses, intra abdominal lymph nodes, and nodular lesion in the left adrenal gland. Tonsillectomy was performed and the pathological result was reported as HS. The patient did not respond to any treatment and had died after 5 months from the date of diagnosis. In conclusion, HS is generally diagnosed at advanced stage, it has limited chemotherapy response and high mortality rates. To understand this rare disease's pathophysiological and clinical features, further investigations are needed., Competing Interests: None
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- 2020
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59. Isolated pituitary fossa metastasis from a primary tonsillar squamous cell carcinoma: case report.
- Author
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Merchant H, Rye DS, and Smith JA
- Subjects
- Biopsy methods, Carcinoma, Squamous Cell therapy, Chemoradiotherapy methods, Horner Syndrome diagnosis, Horner Syndrome etiology, Humans, Male, Middle Aged, Neoplasm Metastasis pathology, Neoplasm Recurrence, Local, Oculomotor Nerve Diseases diagnosis, Oculomotor Nerve Diseases etiology, Palliative Care methods, Radiotherapy methods, Sella Turcica diagnostic imaging, Sella Turcica radiation effects, Treatment Outcome, Carcinoma, Squamous Cell secondary, Positron Emission Tomography Computed Tomography methods, Sella Turcica pathology, Tonsillar Neoplasms pathology
- Abstract
Objective: This paper presents a case of an isolated pituitary fossa metastasis on a background of a previously treated tonsillar squamous cell carcinoma., Case Report: A 64-year-old male, diagnosed with a primary p16-negative squamous cell carcinoma in the right tonsil, was treated with a course of chemoradiotherapy with curative intent. Positron emission tomography/computed tomography, performed at six months post-treatment, revealed a good local response and no distant metastases. The patient was placed on routine follow up at two-monthly intervals. Two months into follow up, he presented with a right-sided oculomotor nerve palsy and partial Horner's syndrome. Imaging and biopsy revealed a pituitary fossa metastasis (p16-negative squamous cell carcinoma), and a further positron emission tomography/computed tomography visualised this lesion. He was deemed unsuitable for further intervention and underwent palliative radiotherapy for symptom control., Conclusion: This case represents the first reported isolated pituitary fossa metastasis from a tonsillar squamous cell carcinoma. A high degree of clinical suspicion is recommended, along with a low threshold for biopsy and a cautioned use of positron emission tomography/computed tomography, when investigating such patients.
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- 2020
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60. Tonsillar follicular large B-cell lymphoma with IRF4 rearrangement causing sleep apnoea.
- Author
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Yu YT, Sakata S, Takeuchi K, Medeiros LJ, and Chang KC
- Subjects
- Child, Genetic Predisposition to Disease, Humans, Lymphoma, B-Cell genetics, Lymphoma, B-Cell pathology, Lymphoma, Follicular genetics, Lymphoma, Follicular pathology, Male, Phenotype, Sleep Apnea Syndromes diagnosis, Tonsillar Neoplasms genetics, Tonsillar Neoplasms pathology, Biomarkers, Tumor genetics, Gene Rearrangement, Interferon Regulatory Factors genetics, Lymphoma, B-Cell complications, Lymphoma, Follicular complications, Sleep Apnea Syndromes etiology, Tonsillar Neoplasms complications
- Abstract
Competing Interests: Competing interests: None declared.
- Published
- 2020
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61. Evaluation of robotic surgery for transoral resection of T1-2 squamous cell carcinoma of the tonsillar fossa.
- Author
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Shenouda K, Rubin F, Garcia D, Badoual C, Bonfils P, and Laccourreye O
- Subjects
- Adult, Aged, Aged, 80 and over, Carcinoma, Squamous Cell pathology, Female, Humans, Male, Middle Aged, Mouth, Neoplasm Staging, Retrospective Studies, Tonsillar Neoplasms pathology, Carcinoma, Squamous Cell surgery, Robotic Surgical Procedures methods, Tonsillar Neoplasms surgery
- Abstract
Goal: To evaluate transoral robotic surgery (TORS) for isolated previously untreated squamous cell carcinoma (SCC) of the tonsillar fossa classified as T1-2., Method: Retrospective analysis of two cohorts of isolated untreated T1-2 tonsillar fossa SCC consecutively operated on by a transoral approach, with (R=21) and without (NR=24) robotic assistance, in the period 2006-2014. Three main (survival, local control, and operative morbidity) and three secondary (pathologic data, incidence and duration of tracheotomy and nasogastric intubation, and hospital stay) endpoints were compared between groups. The significance threshold was set at P< .005., Results: Three- and five-year actuarial survival estimates were 80.2% and 74.5% respectively in group R, and 91.5% and 82.5% respectively in group NR (NS: P=.34). Three- and five-year actuarial local control estimates were 90% and 90% respectively in group R, and 95.8% and 91% respectively in group NR (NS: P=.81). There were no significant differences in morbidity, tracheotomy/nasogastric intubation time, or hospital stay. Positive resection margins (R1) were noted in 38.1% and 16.7% in groups R and NR, respectively (NS: P=.05) without significant impact on 5-year actuarial local control (P=0.78)., Conclusion: Robotic assistance in transoral lateral oropharyngectomy for T1-2 tonsillar fossa SCC did not significantly impact oncologic or functional outcome., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)
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- 2020
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62. Establishment and Validation of a Nomogram for Tonsil Squamous Cell Carcinoma: A Retrospective Study Based on the SEER Database.
- Author
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Li C, Yang J, Zheng S, Xu F, Han D, Bai L, Wei YL, Wang S, and Lyu J
- Subjects
- Aged, Carcinoma, Squamous Cell therapy, Combined Modality Therapy, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prognosis, Retrospective Studies, Survival Rate, Tonsillar Neoplasms therapy, Carcinoma, Squamous Cell pathology, Nomograms, SEER Program statistics & numerical data, Tonsillar Neoplasms pathology
- Abstract
This study aimed to establish and validate a comprehensive nomogram for predicting the cause-specific survival (CSS) probability in tonsillar squamous cell carcinoma (TSCC). We screened and extracted data from the SEER (Surveillance, Epidemiology, and End Results) database for the period 2004 to 2016. We randomly divided the 7243 identified patients into a training cohort (70%) for constructing the model and a validation cohort (30%) for evaluating the model using R software. Multivariate Cox stepwise regression was used to select predictive variables. The concordance index (C-index), the area under the time-dependent receiver operating characteristics curve (AUC), the net reclassification improvement (NRI), the integrated discrimination improvement (IDI), calibration plotting, and decision-curve analysis (DCA) were used to evaluate the model. The multivariate Cox stepwise regression analysis successfully established a nomogram for the 1-, 3-, and 5-year CSS probabilities for TSCC patients. The C-index, AUC, NRI, and IDI were all showed that the model has good discrimination. The calibration plots were very close to the standard lines, indicating that the model has a good degree of calibration, and the DCA curve further illustrated that the model has good clinical validity. We have established the first nomogram for predicting the 1-, 3-, and 5-year CSS probabilities for TSCC based on a large retrospective sample. Our rigorous validation and evaluation indicated that the model can provide useful guidance to clinical workers making clinical decisions about individual patients.
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- 2020
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63. Radical Tonsillectomy and Superior Pharyngeal Constrictor Anatomy: A Cadaveric and Oncologic Specimen Assessment.
- Author
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Amin JD, Kallen ME, and Hatten KM
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- Cadaver, Carcinoma, Squamous Cell pathology, Humans, Palatine Tonsil pathology, Squamous Cell Carcinoma of Head and Neck, Tonsillar Neoplasms pathology, Carcinoma, Squamous Cell surgery, Palatine Tonsil surgery, Robotic Surgical Procedures methods, Tonsillar Neoplasms surgery, Tonsillectomy methods
- Abstract
Introduction: The rise in primary surgical management of oropharyngeal squamous cell carcinoma has led to varying interpretations of the histopathologic evaluation following a radical tonsillectomy. The oncologic margin may be significantly influenced by the morphologic relations and anatomic dimensions of the palatine tonsil and superior pharyngeal constrictor (SPC) muscle., Objective: The aim of this study was to characterize the gross and histologic anatomic features of the palatine tonsil and SPC muscle following an en bloc radical tonsillectomy., Methods: Radical tonsillectomy specimens were collected from cadaveric and oncologic subjects. Specimens were processed using standard histopathologic techniques and were analyzed by a board-certified head and neck pathologist. The thickness of the SPC muscle and relationship to the tonsillar carcinoma were assessed., Results: Six cadaveric and 10 oncologic specimens were analyzed. The mean minimum SPC width for all cadaveric specimens was 1.02 ± 0.50 mm. The mean minimum width for oncologic specimens was 0.76 ± 0.46 mm. The mean distance from tonsil carcinoma to the lateral specimen margin was 1.79 ± 1.39 mm., Conclusion: Due to the limited width of the SPC muscle, a margin in excess of 2 mm may not be attainable in a transoral radical tonsillectomy. Margin status may be ideally determined by the integrity of the SPC muscle in future oncologic studies, rather than an adequate distance measurement., (© 2020 S. Karger AG, Basel.)
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- 2020
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64. Pediatric Tonsillar Synovial Sarcoma- Very Rare Localization: A Case Report and Review of the Literature.
- Author
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Yalçin K, Tüysüz G, Genç M, Özbudak İH, Derin AT, Karaali K, Küpesiz A, and Güler E
- Subjects
- Adult, Deglutition Disorders etiology, Humans, Male, Sarcoma, Synovial complications, Sarcoma, Synovial therapy, Snoring etiology, Tonsillar Neoplasms complications, Tonsillar Neoplasms therapy, Treatment Outcome, Sarcoma, Synovial pathology, Tonsillar Neoplasms pathology
- Abstract
Tonsillar synovial sarcoma is an extremely rare entity and only 9 adult patients have been reported up to now. Here, we describe the first pediatric tonsillar synovial sarcoma of the literature in a patient who presented with a 2-month history of dysphagia and snoring. Clinical and radiological examinations showed that the tumor arose from the right palatine tonsil and narrowed the parapharyngeal space. An incisional biopsy from the palatine tonsil revealed the diagnosis of synovial sarcoma. The patient has underwent total tonsillectomy and received radiotherapy and chemotherapy because of the positive surgical margins. The patient is clinically in good condition and free of tumor 30 months after the initial diagnosis. We achieved a long-term complete remission with a combination of surgery, radiotherapy and chemotherapy in our case. Tonsillar synovial sarcoma should be kept in mind while dealing with tonsillar masses. We can conclude that a multidisciplinary approach is warranted while treating synovial sarcoma with this localization.
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- 2020
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65. Risk of post-operative, pre-radiotherapy contralateral neck recurrence in patients treated with surgery followed by adjuvant radiotherapy for human papilloma virus-associated tonsil cancer.
- Author
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Gershowitz J, Chao HH, Doucette A, Lukens JN, Swisher-McClure S, Weinstein GS, O'Malley BW Jr, Chalian AA, Rassekh CH, Newman JG, Cohen RB, Bauml JM, Aggarwal C, and Lin A
- Subjects
- Adult, Aged, Aged, 80 and over, Carcinoma, Squamous Cell pathology, Carcinoma, Squamous Cell virology, Female, Humans, Lymph Node Excision, Lymphatic Metastasis, Male, Margins of Excision, Middle Aged, Neoplasm Recurrence, Local, Odds Ratio, Papillomaviridae, Postoperative Period, Radiotherapy, Adjuvant methods, Radiotherapy, Intensity-Modulated, Regression Analysis, Retrospective Studies, Risk, Tonsillar Neoplasms pathology, Tonsillar Neoplasms virology, Tumor Burden, Carcinoma, Squamous Cell radiotherapy, Carcinoma, Squamous Cell surgery, Neoplasms, Second Primary etiology, Papillomavirus Infections complications, Tonsillar Neoplasms radiotherapy, Tonsillar Neoplasms surgery
- Abstract
Objective: One approach to reduce treatment-related morbidity for human papilloma virus (HPV)-associated tonsil cancer is omitting radiotherapy to the contralateral neck. Pathologic risk factors for early contralateral neck disease, however, are poorly understood. We report on the risk contralateral neck failures from the time of pre-operative diagnostic imaging to time of planning for adjuvant radiation in a single institution series of HPV-associated tonsillar cancer patients undergoing surgery followed by radiotherapy (RT)., Methods: Retrospective analysis of 123 patients with T1 - T3 HPV-positive tonsillar squamous cell carcinoma treated between 2010 and 2016 with transoral robotic surgery and selective ipsilateral neck dissection followed by adjuvant RT. Contralateral neck recurrence was classified as the detection of a pathologic node in the contralateral neck prior to initiation of adjuvant RT., Results: Seven patients (5.7%) developed contralateral neck disease/failure between the time of pre-operative diagnostic neck imaging and time of planning of adjuvant radiation. Increased ratio of positive/resected nodes [odds ratio (OR) 1.073, p = 0.005] was significantly associated with increased risk of contralateral neck recurrence, with a trend found for close/positive margins (OR 5.355, p = 0.06), tumor size (OR 2.046, p = 0.09), and total number of nodes positive (OR 1.179, p = 0.062)., Conclusions: Patients who develop very early contralateral neck disease, between completion of ipsilateral neck dissection and the initiation of radiotherapy, have a higher ratio of positive nodes to total nodes resected in the ipsilateral neck. These findings suggest that proper selection of patients for omission of treatment of the contralateral, node-negative neck should be made with this in mind, with future studies needed to document the impact on toxicity and disease outcomes from such an approach., Advances in Knowledge: Pathologic risk factors in the dissected, ipsilateral neck in patients with tonsil cancer may inform the risk of contralateral neck failure. Patient selection for future, prospective efforts to examine sparing of the contralateral neck need to be based with these risk factors in mind.
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- 2019
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66. Ciliated HPV-Related Carcinoma: A Diagnostic Challenge on Frozen Section.
- Author
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Navale P, Genden EM, and Beasley MB
- Subjects
- Cilia pathology, Frozen Sections, Humans, Male, Middle Aged, Papillomavirus Infections complications, Squamous Cell Carcinoma of Head and Neck diagnosis, Squamous Cell Carcinoma of Head and Neck pathology, Tonsillar Neoplasms diagnosis, Tonsillar Neoplasms pathology
- Abstract
Oropharyngeal squamous cell carcinomas associated with high risk HPV show a wide morphological spectrum, including papillary, adenosquamous, lymphoepithelioma-like and sarcomatoid. We report an interesting case of ciliated HPV-related carcinoma arising from tonsillar tissue in a 55-year-old man which was associated with HPV33. This rare variant has been described in only a handful of cases in the literature, and to our knowledge this is the first case specifically associated with HPV33. The presence of cilia is a potential diagnostic problem as it has been traditionally considered a feature of benignancy, and could pose a particular challenge on frozen section. The diagnostic challenges, differential diagnosis of this tumor and the association with HPV33 are discussed.
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- 2019
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67. Limiting radiotherapy field to ipsilateral side only in unresected lateralised HPV positive N2b squamous cell carcinoma of the tonsil.
- Author
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Iqbal MS, Kovarik J, and Kelly C
- Subjects
- Carcinoma, Squamous Cell pathology, Female, Humans, Male, Retrospective Studies, Tonsillar Neoplasms pathology, Carcinoma, Squamous Cell radiotherapy, Carcinoma, Squamous Cell virology, Papillomavirus Infections complications, Tonsillar Neoplasms radiotherapy, Tonsillar Neoplasms virology
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- 2019
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68. Primary Tonsillar Epithelioid Follicular Dendritic Cell Sarcoma: Report of a Rare Case Mimicking Undifferentiated Carcinoma and a Brief Review of the Literature.
- Author
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Wu B, Lim CM, and Petersson F
- Subjects
- Carcinoma diagnosis, Carcinoma pathology, Diagnosis, Differential, Humans, Male, Middle Aged, Dendritic Cell Sarcoma, Follicular diagnosis, Dendritic Cell Sarcoma, Follicular pathology, Tonsillar Neoplasms diagnosis, Tonsillar Neoplasms pathology
- Abstract
We present a 52 years old male with a left tonsillar follicular dendritic cell sarcoma with prominent epithelioid features that on light microscopical examination bore a striking resemblance to a lymphoepithelial or undifferentiated carcinoma. The tumor was immunohistochemically positive for CD21 and CD35 and negative for cytokeratins. Two distinct histopathological features (both present in our case) that may serve as clues to the correct diagnosis on light microscopical examination were formation of ectatic pseudovascular spaces lined by malignant cells and the presence of non-neoplastic multinucleated giant cells. Familiarity with the above-mentioned morphological clues, and awareness that this tumour may occur in anatomical sites outside the lymph node, are essential for accurate diagnosis.
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- 2019
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69. Oncological outcome following initiation of treatment for stage III and IV HPV negative oropharyngeal cancers with transoral robotic surgery (TORS).
- Author
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Dabas S, Gupta K, Sharma AK, Shukla H, Ranjan R, and Sharma DK
- Subjects
- Adult, Aged, Aged, 80 and over, Chemoradiotherapy, Adjuvant, Disease-Free Survival, Female, Head and Neck Neoplasms pathology, Head and Neck Neoplasms surgery, Humans, India, Male, Middle Aged, Neoplasm Staging, Oropharyngeal Neoplasms pathology, Palatal Neoplasms pathology, Palatal Neoplasms surgery, Radiotherapy, Adjuvant, Squamous Cell Carcinoma of Head and Neck pathology, Survival Rate, Tongue Neoplasms pathology, Tongue Neoplasms surgery, Tonsillar Neoplasms pathology, Tonsillar Neoplasms surgery, Oropharyngeal Neoplasms surgery, Otorhinolaryngologic Surgical Procedures methods, Robotic Surgical Procedures methods, Squamous Cell Carcinoma of Head and Neck surgery
- Abstract
Objective: To report long-term oncological and functional outcome of Transoral Robotic Surgery escalated treatment including radiotherapy or chemoradiotherapy for Stage III-IV HPV negative oropharyngeal malignancies., Method: From March 2013 to September 2015, 153 patients with oropharyngeal carcinoma were included in the study. Patients were evaluated for disease free survival, overall survival and post-treatment functional outcomes., Results: 153 patients (96 males and 57 females) underwent TORS for oropharyngeal carcinoma. 142 patients on final histopathology had stage III and IV disease and received adjuvant treatment based on final histopathology. One hundred and sixteen (81.7%) patients were disease free on average follow-up of 48 months with an overall survival of 91.5% at mean follow-up of 48 months., Conclusion: TORS can be used to intensify treatment of Stage III/IV oropharyngeal carcinoma and avoid early and late toxicities due to higher doses of upfront RT/CTRT and achieve better oncological outcome., (Copyright © 2019 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.)
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- 2019
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70. Solitary cystic metastatic lymph node of occult human papillomavirus-related oropharyngeal cancer mimicking second branchial cleft cyst: A case report.
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Liang HH, Chen CY, Chen WY, Chen TM, and Chan WP
- Subjects
- Carcinoma, Squamous Cell secondary, Carcinoma, Squamous Cell virology, Diagnosis, Differential, Humans, Lymph Nodes pathology, Lymph Nodes virology, Male, Middle Aged, Neck pathology, Neck virology, Neck Dissection, Neoplasms, Cystic, Mucinous, and Serous secondary, Neoplasms, Cystic, Mucinous, and Serous virology, Neoplasms, Unknown Primary pathology, Neoplasms, Unknown Primary virology, Oropharyngeal Neoplasms secondary, Oropharyngeal Neoplasms virology, Papillomaviridae, Papillomavirus Infections complications, Papillomavirus Infections virology, Tonsillar Neoplasms diagnosis, Tonsillar Neoplasms pathology, Tonsillar Neoplasms virology, Branchioma diagnosis, Carcinoma, Squamous Cell diagnosis, Lymphatic Metastasis diagnosis, Neoplasms, Cystic, Mucinous, and Serous diagnosis, Neoplasms, Unknown Primary diagnosis, Oropharyngeal Neoplasms diagnosis
- Abstract
Rationale: Human papillomavirus (HPV)-related oropharyngeal cancer is becoming more common, the primary cancer AQ4 usually occult and appearing only as cystic cervical lymph node (LN) metastasis. Distinguishing between a benign cystic lesion and cystic LN metastasis is challenging given their similar radiologic and histologic appearances., Patient Concerns: A 54-year-old man presented with a bulging cystic mass measuring 6.4cm on the right side of neck., Diagnoses: Postexcision diagnosis was second branchial cleft cyst. After 2 years, the cystic mass recurred, and HPV-related tonsillar squamous cell carcinoma with cystic metastatic LNs was confirmed after wide tonsillectomy and neck dissection. The previous cystic lesion proved to be a cystic metastatic LN from the same malignancy with additional p16 immunostain., Interventions: The patient was treated with adjuvant concurrent chemoradiation therapy., Outcomes: The patient was followed up in the outpatient department with no evidence of recurrence after 1 year., Lessons: When an adult has a cystic mass in the upper neck, we must rigorously exclude it as a cystic metastatic LN of occult HPV-related oropharyngeal cancer. Additional p16 staining might be helpful.
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- 2019
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71. Cerebellar Hypermetabolism in a Case of Paraneoplastic Cerebellar Syndrome With the Primary Lymphoepithelial Carcinoma in Tonsil.
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Wang J, Wang W, Zhao Y, and Cui R
- Subjects
- Aged, Cerebellum diagnostic imaging, Fluorodeoxyglucose F18, Humans, Lymphatic Metastasis, Magnetic Resonance Imaging, Male, Neoplasms, Glandular and Epithelial complications, Neoplasms, Glandular and Epithelial diagnosis, Positron Emission Tomography Computed Tomography, Tonsillar Neoplasms complications, Tonsillar Neoplasms diagnostic imaging, Cerebellum metabolism, Neoplasms, Glandular and Epithelial metabolism, Neoplasms, Glandular and Epithelial pathology, Paraneoplastic Cerebellar Degeneration complications, Tonsillar Neoplasms metabolism, Tonsillar Neoplasms pathology
- Abstract
A 70-year-old man with cerebellar syndromes was clinically diagnosed as paraneoplastic cerebellar degeneration and underwent whole-body F-FDG PET/CT imaging for screening primary tumor. Intensely elevated tracer uptake in both cerebellar hemispheres was revealed, whereas no abnormality was found in MRI. Increased tracer uptake and swelling of the left tonsil and a cervical lymph node were found at the same time, suggesting neoplasm in tonsil with lymph node metastasis. Pathological examination demonstrated lymphoepithelial carcinoma of the left tonsil.
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- 2019
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72. Predicting radiation dosimetric distribution in different regions of the jaw in patients receiving radiotherapy for squamous cell carcinoma of the tonsil.
- Author
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Tsai CJ, Verma N, Owosho AA, Hilden P, Leeman J, Yom S, Huryn JM, Lee NY, and Estilo CL
- Subjects
- Aged, Carcinoma, Squamous Cell pathology, Databases, Factual, Dose-Response Relationship, Radiation, Female, Humans, Male, Middle Aged, Predictive Value of Tests, Radiometry, Radiotherapy Dosage, Radiotherapy, Conformal methods, Reproducibility of Results, Retrospective Studies, Risk Assessment, Tonsillar Neoplasms pathology, Treatment Outcome, Carcinoma, Squamous Cell radiotherapy, Jaw radiation effects, Radiation Injuries prevention & control, Radiotherapy, Conformal adverse effects, Tonsillar Neoplasms radiotherapy
- Abstract
Background: Radiotherapy (RT), the main treatment for patients with head and neck cancer, can lead to dental complications., Methods: We identified 244 patients with squamous cell carcinoma of the tonsil treated with RT from 2004 to 2013. For each patient, we contoured the 10 tooth-bearing regions and calculated the radiation dose (gray, Gy) to each region. From this data set, we built two predictive models to determine the expected maximum radiation dose, one for the non-molar regions and another for the molar regions., Results: For the non-molars, the final model included location, T-classification, and overall stage, with a median absolute prediction error of 7.0 Gy. For the molars, the final model included location, T-classification, overall stage, and treatment year, with a median absolute error of 6.0 Gy., Conclusions: Our current model offers a good estimation of the maximum radiation dose delivered to different regions of the jaw; future work will independently validate these models., (© 2019 Wiley Periodicals, Inc.)
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- 2019
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73. All-optical Reflection-mode Microscopic Histology of Unstained Human Tissues.
- Author
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Abbasi S, Le M, Sonier B, Dinakaran D, Bigras G, Bell K, Mackey JR, and Haji Reza P
- Subjects
- Breast Neoplasms diagnostic imaging, Female, Gastrointestinal Neoplasms diagnostic imaging, Humans, Pancreatic Neoplasms diagnostic imaging, Tonsillar Neoplasms diagnostic imaging, Breast Neoplasms pathology, Eosine Yellowish-(YS) chemistry, Gastrointestinal Neoplasms pathology, Hematoxylin chemistry, Microscopy methods, Pancreatic Neoplasms pathology, Tonsillar Neoplasms pathology
- Abstract
Surgical oncologists depend heavily on visual field acuity during cancer resection surgeries for in-situ margin assessment. Clinicians must wait up to two weeks for results from a pathology lab to confirm a post-operative diagnosis, potentially resulting in subsequent treatments. Currently, there are no clinical tools that can visualize diagnostically pertinent tissue information in-situ. Here, we present the first microscopy capable of non-contact label-free visualization of human cellular morphology in a reflection-mode apparatus. This is possible with the recently reported imaging modality called photoacoustic remote sensing microscopy which enables non-contact detection of optical absorption contrast. By taking advantage of the 266-nanometer optical absorption peak of DNA, photoacoustic remote sensing is efficacious in recovering qualitatively similar nuclear information in comparison to that provided by the hematoxylin stain in the gold-standard hematoxylin and eosin (H&E) prepared samples. A photoacoustic remote sensing system was employed utilizing a 266-nanometer pulsed excitation beam to induce photoacoustic pressures within the sample resulting in refractive index modulation of the optical absorber. A 1310-nanometer continuous-wave interrogation beam detects these perturbed regions as back reflected intensity variations due to the changes in the local optical properties. Using this technique, clinically useful histologic images of human tissue samples including breast cancer (invasive ductal carcinoma), tonsil, gastrointestinal, and pancreatic tissue images were formed. These were qualitatively comparable to standard H&E prepared samples.
- Published
- 2019
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74. [One case of metastatic lymph node presented sarcomatoid differentiation of tonsillar squamous cell carcinoma].
- Author
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Gao X, Cao HN, Li J, Li CS, Liu HY, and Li YT
- Subjects
- Aged, Carcinoma, Squamous Cell secondary, Carcinoma, Squamous Cell therapy, Cell Differentiation, Fatal Outcome, Humans, Lung Neoplasms secondary, Lymphatic Metastasis pathology, Sarcoma therapy, Tonsillar Neoplasms therapy, Carcinoma, Squamous Cell pathology, Lymph Nodes pathology, Sarcoma pathology, Tonsillar Neoplasms pathology
- Published
- 2019
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- View/download PDF
75. Ipsilateral neck radiotherapy in N2b well-lateralized tonsil cancer - Approach with caution.
- Author
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Maskell D, Buckley H, Sission K, Roques T, and Geropantas K
- Subjects
- Adult, Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Carcinoma, Squamous Cell pathology, Chemoradiotherapy, Cisplatin administration & dosage, Female, Fluorouracil administration & dosage, Human papillomavirus 16 isolation & purification, Humans, Male, Middle Aged, Retrospective Studies, Tonsillar Neoplasms pathology, Carcinoma, Squamous Cell therapy, Neoplasm Recurrence, Local pathology, Radiotherapy, Intensity-Modulated methods, Tonsillar Neoplasms therapy
- Abstract
Background: Treatment of the uninvolved neck in well-lateralized tonsillar squamous cell carcinoma is controversial. We became concerned after a number of contralateral neck recurrences (CNRs) in patients receiving ipsilateral radiotherapy (RT)., Methods: This is a single center retrospective series including patients with well-lateralized tonsillar cancer treated with ipsilateral neck RT between 2004 and 2011., Results: We identified 53 patients treated with ipsilateral neck RT during the study period. The rate of CNR was 7.5% (4 of 53). All four patients had p16-positive, T1, N2b, M0 tumors. The subgroup of patients with N2b disease (28 of 53) had a CNR of 14.3%. We subsequently switched to treat patients with N2b with bilateral neck RT. We analyzed the outcomes of 23 patients with N2b treated with bilateral neck intensity-modulated RT (IMRT) and observed no CNRs., Conclusions: We observed a higher than expected rate of CNR in the N2b population. Bilateral neck IMRT for these patients represents a safe alternative., (© 2019 Wiley Periodicals, Inc.)
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- 2019
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76. Importance of timing in staging head and neck cancer: cervical adenopathy post-tonsillectomy mimicking malignancy.
- Author
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Bucknell NW, Dixon BJ, Hoffman MS, and McDowell LJ
- Subjects
- Adult, Diagnosis, Differential, Head and Neck Neoplasms diagnostic imaging, Humans, Male, Neoplasm Staging, Positron Emission Tomography Computed Tomography, Time Factors, Tonsillar Neoplasms diagnostic imaging, Head and Neck Neoplasms pathology, Lymphadenopathy diagnostic imaging, Tonsillar Neoplasms pathology, Tonsillectomy
- Published
- 2019
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- View/download PDF
77. Lymphangiofibrolipomatous hamartomaous polyp of tonsil.
- Author
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Mehta S, Jha S, Adhya AK, and Mitra S
- Subjects
- Adult, Hamartoma surgery, Humans, Male, Polyps surgery, Tonsillar Neoplasms surgery, Hamartoma pathology, Polyps pathology, Tonsillar Neoplasms pathology
- Abstract
Benign tumours of the tonsils are rare. Majority of these lesions are diagnosed as squamous papilloma. Hamartoma is a benign tumor-like malformation. Hamartoma in tonsils is unique and only a few anecdotal cases are reported until now. Tonsillar hamartoma usually presents as unilateral or bilateral polyp with clinical features of dysphagia or foreign body sensation. Histopathologically, normal tissues are noted in a haphazard or disorganised way. We hereby present a case of 31-year-old male patient with tonsillar hamartomatous polyp presenting with the symptom of a foreign body sensation in the throat. The diagnosis of this entity and its distinction from other clinico-pathological mimickers require histopathological examination and awareness. A complete surgical excision is curative without any evidence of disease recurrence., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2019
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78. Tonsil Cancer.
- Author
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Gooi Z and Agrawal N
- Subjects
- Biopsy, Humans, Male, Middle Aged, Papillomavirus Infections complications, Carcinoma, Squamous Cell pathology, Palatine Tonsil pathology, Tonsillar Neoplasms pathology
- Published
- 2019
- Full Text
- View/download PDF
79. Composite lymphoma comprising mantle cell lymphoma and Epstein-Barr virus positive classic Hodgkin lymphoma: A rare case.
- Author
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Sharma S, Singh V, Bisaria D, and Tangri R
- Subjects
- Composite Lymphoma surgery, Herpesvirus 4, Human, Histocytochemistry, Hodgkin Disease complications, Hodgkin Disease pathology, Hodgkin Disease surgery, Humans, Immunohistochemistry, Lymphoma, Mantle-Cell complications, Lymphoma, Mantle-Cell pathology, Lymphoma, Mantle-Cell surgery, Male, Middle Aged, Tonsillar Neoplasms surgery, Tonsillectomy, Composite Lymphoma diagnosis, Composite Lymphoma pathology, Hodgkin Disease diagnosis, Lymphoma, Mantle-Cell diagnosis, Tonsillar Neoplasms diagnosis, Tonsillar Neoplasms pathology
- Abstract
Competing Interests: There are no conflicts of interest
- Published
- 2019
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80. Transoral endoscopic video-assisted lateral oropharyngeal resection: A reliable technique for early-stage tonsil tumours, our experience of 19 patients.
- Author
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Kershaw EL and Jose J
- Subjects
- Adult, Aged, Female, Humans, Male, Middle Aged, Neoplasm Staging, Tonsillar Neoplasms pathology, Natural Orifice Endoscopic Surgery methods, Oropharynx surgery, Tonsillar Neoplasms surgery, Video-Assisted Surgery methods
- Published
- 2019
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- View/download PDF
81. Spontaneous hematoma of the thigh associated with antiproteinase-3 antibody in a patient with metastatic squamous cell carcinoma treated with nivolumab.
- Author
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Keung YK and Hu EH
- Subjects
- Carcinoma, Squamous Cell immunology, Carcinoma, Squamous Cell secondary, Humans, Male, Middle Aged, Thigh, Antineoplastic Agents, Immunological adverse effects, Carcinoma, Squamous Cell drug therapy, Hematoma etiology, Myeloblastin immunology, Nivolumab adverse effects, Programmed Cell Death 1 Receptor antagonists & inhibitors, Tonsillar Neoplasms pathology
- Abstract
We report an unusual case of spontaneous intramuscular hematoma associated with antiproteinase 3 antibody in a patient with metastatic squamous cell carcinoma receiving nivolumab and the medical literature is reviewed.
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- 2019
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82. [Tonsil synovial sarcoma with gastric and other systemic metastases:a case report].
- Author
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Wang H, Chen YQ, Zeng XZ, Guo SR, and Chen GQ
- Subjects
- Humans, Neoplasm Metastasis, Sarcoma, Synovial secondary, Stomach Neoplasms secondary, Tonsillar Neoplasms pathology
- Published
- 2019
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- View/download PDF
83. Tonsillar Kaposi sarcoma in an HIV-negative patient.
- Author
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Latini A, Alei L, Covello R, Cristaudo A, Colafigli M, Donà MG, Orsini D, Morrone A, Pellini R, and Pichi B
- Subjects
- Adult, Humans, Male, Sarcoma, Kaposi pathology, Tonsillar Neoplasms pathology, HIV Seronegativity, Sarcoma, Kaposi diagnosis, Tonsillar Neoplasms diagnosis
- Published
- 2019
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- View/download PDF
84. A case of palatine tonsillar metastasis of lung adenocarcinoma: A CARE-compliant article.
- Author
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Chen CC, Lee CT, Chang SL, and Tsai MC
- Subjects
- Adenocarcinoma pathology, Aged, Humans, Male, Tonsillar Neoplasms pathology, Adenocarcinoma secondary, Lung Neoplasms pathology, Palatine Tonsil pathology, Tonsillar Neoplasms secondary
- Abstract
Rationale: Palatine tonsil is an extremely rare site for metastatic disease, accounting for 0.8% of malignant tonsillar neoplasms. To the best of our knowledge, this is the first report of metastatic adenocarcinoma in the tonsil treated with wide excision and targeted therapy, with no local recurrence 6 months postoperatively., Patient Concerns: A 75-year-old man presented hemoptysis and mild productive cough for 2 weeks., Diagnoses: Palatine tonsil metastasis from lung adenocarcinoma, pT2bN0M1b, stage IVA, was confirmed., Interventions: Wide excision of primary lung tumor and metastatic tonsil carcinoma has been performed, and the patient was undergoing targeted therapy with the epidermal growth factor receptor inhibitor afatinib., Outcomes: There was no local recurrence in the oropharynx 6 months postoperatively., Lessons: We aim at highlighting the importance of a thorough evaluation for suspicion of tonsillar enlargement, which might be a sign of a primary malignancy elsewhere.
- Published
- 2019
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85. Treatment of Tonsillar Carcinoma following Nononcologic Tonsillectomy: Efficacy of Transoral Robotic Revision Tonsillectomy.
- Author
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Gobillot TA, Kaka AS, Patel SA, Rodriguez C, Cannon RB, Futran ND, and Houlton JJ
- Subjects
- Adult, Aged, Carcinoma, Squamous Cell mortality, Carcinoma, Squamous Cell pathology, Disease-Free Survival, Female, Humans, Male, Middle Aged, Reoperation, Retrospective Studies, Survival Rate, Tonsillar Neoplasms mortality, Tonsillar Neoplasms pathology, Treatment Outcome, Carcinoma, Squamous Cell surgery, Robotic Surgical Procedures, Tonsillar Neoplasms surgery, Tonsillectomy
- Abstract
Objective: To evaluate whether transoral robotic surgery (TORS) is a suitable treatment approach for patients diagnosed with tonsillar carcinoma after a standard palatine tonsillectomy., Study Design: Retrospective cohort study., Setting: Tertiary care medical center., Subjects and Methods: Patients who underwent TORS at the University of Washington from 2010 to 2017 (n = 150) were identified. All patients who were diagnosed with tonsillar carcinoma following a nononcologic tonsillectomy and subsequently underwent TORS radical tonsillectomy were included (n = 14). Tumor stage-matched subjects (n = 44) were included who did not undergo standard tonsillectomy prior to TORS. Our primary outcome was final margin status. Secondary outcomes were presence of residual tumor, receipt and dose of postoperative adjuvant therapy, disease-free survival (DFS), and disease-specific survival. Patients with <6 months of follow-up following definitive treatment were excluded from survival analyses., Results: Final margin status was clear in all subjects. Residual tumor was not identified in 13 of 14 (92.9%) prior-tonsillectomy subjects following TORS radical tonsillectomy. Seven of 14 (50%) prior-tonsillectomy subjects and 12 of 44 (27.3%) TORS-matched subjects did not require adjuvant therapy due to favorable pathology. Among subjects who received post-TORS radiation therapy (RT) at our institution, RT dose reduction was achieved in 3 of 4 (75%) prior-tonsillectomy subjects and 21 of 24 (87.5%) TORS-matched subjects. Ten of 14 (71.4%) prior-tonsillectomy subjects and 31 of 44 (70.5%) TORS-matched subjects avoided post-TORS chemotherapy. DFS was not significantly different ( P = .87) between prior-tonsillectomy and TORS-matched groups, and no subjects died of related disease., Conclusions: Patients diagnosed with tonsillar carcinoma following a prior nononcologic standard palatine tonsillectomy are suitable candidates for revision surgery with TORS radical tonsillectomy.
- Published
- 2019
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86. A rare case of a solitary extramedullary plasmacytoma of the palatine tonsil.
- Author
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Suska A, Małkowski B, Halaszka K, Gałązka K, Czerniuk MR, and Jurczyszyn A
- Subjects
- Humans, Male, Middle Aged, Palatine Tonsil pathology, Plasmacytoma pathology, Tonsillar Neoplasms pathology, Palatine Tonsil diagnostic imaging, Plasmacytoma diagnostic imaging, Tonsillar Neoplasms diagnostic imaging
- Published
- 2019
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- View/download PDF
87. What is causing this patient's tonsillar lesion and enlarged lymph node?
- Author
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Roberts A and Rizzolo D
- Subjects
- Adult, Carcinoma, Squamous Cell etiology, Carcinoma, Squamous Cell pathology, Diagnosis, Differential, Humans, Lymph Nodes diagnostic imaging, Lymph Nodes pathology, Lymphatic Metastasis diagnostic imaging, Lymphatic Metastasis pathology, Male, Papillomavirus Infections complications, Tonsillar Neoplasms etiology, Tonsillar Neoplasms pathology, Tonsillectomy, Treatment Outcome, Ultrasonography, Carcinoma, Squamous Cell diagnostic imaging, Carcinoma, Squamous Cell surgery, Tonsillar Neoplasms diagnostic imaging, Tonsillar Neoplasms surgery
- Published
- 2019
- Full Text
- View/download PDF
88. A case report of an extranodal NK/T-cell lymphoma nasal type, occurring primarily in eyes with masquerade syndrome.
- Author
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Zhang F, Duan X, and Liu K
- Subjects
- Diagnosis, Differential, Disease Progression, Fatal Outcome, Female, Glaucoma diagnosis, Glaucoma etiology, Humans, Magnetic Resonance Imaging methods, Middle Aged, Patient Care Management methods, Tomography, X-Ray Computed methods, Vision Disorders diagnosis, Vision Disorders etiology, Eye Neoplasms complications, Eye Neoplasms diagnosis, Eye Neoplasms pathology, Lymphoma, Extranodal NK-T-Cell complications, Lymphoma, Extranodal NK-T-Cell diagnosis, Lymphoma, Extranodal NK-T-Cell pathology, Lymphoma, Extranodal NK-T-Cell therapy, Nasopharyngeal Neoplasms diagnosis, Nasopharyngeal Neoplasms pathology, Nasopharyngeal Neoplasms therapy, Tonsillar Neoplasms diagnosis, Tonsillar Neoplasms pathology, Tonsillar Neoplasms therapy, Uveitis, Anterior diagnosis
- Abstract
Rationale: Extranodal natural killer T-cell lymphoma nasal type (ENKL) is an extremely rare tumor with a very low survival rate. In recent decades, only a few ENKL cases have been published. Presenting a special ENKL case lead the authors to emphasize the primary features of ENKL in early diagnosis and therapy. Here we report an unusual ENKL case which was initially found in the eyes and presented as masqueraded uveitis PATIENT CONCERNS:: A 55 years old female, with vision loss in the right eye for approximately 6 months, and vision blurry, redness and pain in the left eye for 2 weeks, was referred to our hospital., Diagnosis: Clinical examinations and images demonstrated bilateral anterior uveitis, retinal and choroidal detachment, and secondary glaucoma. After 3 months, the patient began to present a sore throat, fever, and headaches. The computed tomography (CT) and magnetic resonance imaging (MRI) of her skull demonstrated nothing positive. One month later, a neoplasm was found in her nasopharynx and tonsil, which was confirmed, by histopathology, as ENKL INTERVENTIONS:: This patient was prescribed with steroid for 3 months because of the first diagnosis by the ophthalmologist. After the other symptoms like a sore throat, fever and headaches occurred, symptomatic treatment was given. Unfortunately, when the real cause was found, the patient could not tolerate the other treatment for ENKL., Outcomes: Since the patient was treated with steroid without improvement, she died due to the septic shock and multiple organ failure., Lessons: Clinicians should always be cautious to ENKL which can be easily be misdiagnosed in the early stage. Early diagnosis and appropriate treatment are keys to raise the survival rate of ENKL patients.
- Published
- 2019
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89. Occult malignancy in pediatric tonsil and adenoid surgeries - A national survey.
- Author
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Lifshitz G, Gruber M, and Ronen O
- Subjects
- Adenoidectomy, Adenoids pathology, Adolescent, Burkitt Lymphoma pathology, Child, Child, Preschool, Humans, Incidence, Incidental Findings, Infant, Infant, Newborn, Israel epidemiology, Registries, Retrospective Studies, Tonsillar Neoplasms pathology, Tonsillectomy, Burkitt Lymphoma epidemiology, Tonsillar Neoplasms epidemiology
- Abstract
Objective: To evaluate the incidence of tonsil and adenoid malignancy in pediatric patients in Israel compared to the known literature and to revisit the common practice of routine histopathologic examination of tonsils and adenoids., Methods: Analysis of the Israel National Cancer Registry data on pediatric tonsil and adenoid malignancies between the years 2005 and 2015, and a systematic literature review of all relevant articles that reported on malignancies amongst pediatric patients who underwent tonsillectomy with or without adenoidectomy., Results: Only seven cases of tonsillar malignancies were documented out of 152,352 (0.0052%) surgeries in the pediatric population. All malignancies were lymphoproliferative and mainly Burkitt's lymphoma. In our medical center no malignancy was found in 2165 patients in the same age groups and time period. We found the incidence of tonsillar malignancy in Israel to be significantly lower (p = 0.013) compared to the previously described literature., Conclusion: The incidence of malignancy in routine histopathological examination of tonsils and adenoids is Israel is very low when compared to the known literature. According to these results, we suggest that routine histopathological examination of all such samples is not clinically justified., (Copyright © 2018 Elsevier B.V. All rights reserved.)
- Published
- 2019
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90. [A large right tonsil].
- Author
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Bellahsen-Harrar Y, Guillaubey C, Merzougui N, Baglin AC, and Wassef M
- Subjects
- Aged, Humans, Male, Dendritic Cell Sarcoma, Follicular pathology, Tonsillar Neoplasms pathology
- Published
- 2019
- Full Text
- View/download PDF
91. Extranodal involvement of diffuse large B-cell lymphoma in the head and neck: An indicator of good prognosis.
- Author
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Lee DY, Kang K, Jung H, Park YM, Cho JG, Baek SK, Kwon SY, Jung KY, and Woo JS
- Subjects
- Adult, Aged, Cause of Death, Female, Head and Neck Neoplasms metabolism, Head and Neck Neoplasms mortality, Humans, Interferon Regulatory Factors metabolism, L-Lactate Dehydrogenase metabolism, Lymphoma, Large B-Cell, Diffuse metabolism, Lymphoma, Large B-Cell, Diffuse mortality, Male, Middle Aged, Nasopharyngeal Neoplasms metabolism, Nasopharyngeal Neoplasms mortality, Nasopharyngeal Neoplasms pathology, Neoplasm Staging, Neprilysin metabolism, Palatine Tonsil pathology, Prognosis, Proto-Oncogene Proteins c-bcl-6 metabolism, Retrospective Studies, Survival Rate, Tongue pathology, Tonsillar Neoplasms metabolism, Tonsillar Neoplasms mortality, Tonsillar Neoplasms pathology, Head and Neck Neoplasms pathology, Lymph Nodes pathology, Lymphoma, Large B-Cell, Diffuse pathology
- Abstract
Objective: In this study, we analyzed clinicopathological characteristics and survival outcomes according to extranodal involvement of diffuse large B-cell lymphoma (DLBCL) in the head and neck., Methods: A retrospective analysis was conducted on 110 patients from 2004 to 2014 with CD20-positive DLBCL involving the head and neck area. Patients were categorized into two groups, extranodal and nodal, according to involvement of extranodal sites in the head and neck. Outcome measurements for the groups included clinical response to treatment and recurrence rates., Results: Palatine tonsils were the most frequently involved extranodal site in the head and neck (29.1%). Among clinicopathological parameters, proportion of patients with lactate dehydrogenase over 350 IU/L (p=0.033), cell of origin (p<0.001), and treatment outcomes (p=0.007) were significantly different between the two groups. Among cell origin markers CD10, Bcl6, and MUM1, MUM1 was significantly correlated with extranodal involvement (p=0.029). Recurrence rates were similar between groups, while disease-specific survival was significantly higher in the extranodal group (p=0.011). Disease-specific survival of the extranodal group was also higher than the nodal group with extranodal involvement of other body sites (p=0.010). Among patients with negative expression of CD10 (p=0.015), Bcl6 (p=0.018), and MUM1 (p=0.005), survival was longer in the extranodal than the nodal group., Conclusions: DLBCL patients with extranodal involvement of the head and neck may have longer survival outcomes than patients with solely nodal involvement. Increased survival may be more prominent in patients with negative expression of CD10, Bcl6, and MUM1., (Copyright © 2018 Elsevier B.V. All rights reserved.)
- Published
- 2019
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- View/download PDF
92. Initial presentation of tonsillar carcinoma with candidiasis.
- Author
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Shih CP and Tsai WC
- Subjects
- Biopsy, Fine-Needle, Candida albicans isolation & purification, Candida albicans pathogenicity, Candidiasis diagnostic imaging, Candidiasis microbiology, Chemoradiotherapy, Endoscopy, Humans, Male, Middle Aged, Squamous Cell Carcinoma of Head and Neck diagnostic imaging, Squamous Cell Carcinoma of Head and Neck microbiology, Squamous Cell Carcinoma of Head and Neck therapy, Tonsillar Neoplasms diagnostic imaging, Tonsillar Neoplasms microbiology, Tonsillar Neoplasms therapy, Candidiasis pathology, Squamous Cell Carcinoma of Head and Neck pathology, Tonsillar Neoplasms pathology
- Abstract
Competing Interests: None
- Published
- 2019
- Full Text
- View/download PDF
93. Concurrent Squamous Cell Carcinoma and Chronic Lymphocytic Leukemia Presenting as an Enlarging Neck Mass.
- Author
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Bhinder P, Chahin M, and Zuberi L
- Subjects
- Biopsy, Carcinoma, Squamous Cell therapy, Disease Progression, Female, Humans, Laryngoscopy, Leukemia, Lymphocytic, Chronic, B-Cell therapy, Middle Aged, Neoplasms, Multiple Primary, Radiotherapy, Rituximab therapeutic use, Tonsillar Neoplasms therapy, Carcinoma, Squamous Cell pathology, Leukemia, Lymphocytic, Chronic, B-Cell pathology, Tonsillar Neoplasms pathology
- Abstract
Chronic lymphocytic leukemia (CLL) patients are at an increased risk for developing more aggressive lymphomas via Richter's transformation and of developing secondary malignancies. Despite the known association for secondary cancers, oropharyngeal cancers occur rarely. We present a case of a woman with a history of CLL who presented to our facility via transfer for impending airway compromise. Her initial workup was consistent with CLL; however, biopsies were taken of the neck mass because of its aggressive nature. She was treated with rituximab with good response. Final pathology showed evidence of CLL and tonsillar squamous cell carcinoma (SCC). Direct laryngoscopy and further biopsies yielded a diagnosis of unresectable oropharyngeal SCC. She was to be treated with chemotherapy and radiation for her SCC while holding treatment for CLL. This case demonstrates a rare and unexpected concurrent diagnosis.
- Published
- 2019
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- View/download PDF
94. Transoral Robotic Surgery With Transoral Retropharyngeal Lymph Node Dissection in Patients With Tonsillar Cancer: Anatomical Points, Surgical Techniques, and Clinical Usefulness.
- Author
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Park YM, Cha D, Koh YW, Choi EC, and Kim SH
- Subjects
- Adult, Aged, Aged, 80 and over, Carcinoma, Squamous Cell secondary, Female, Humans, Lymphatic Metastasis, Male, Middle Aged, Neck, Tonsillar Neoplasms pathology, Carcinoma, Squamous Cell surgery, Lymph Node Excision methods, Neck Dissection methods, Robotic Surgical Procedures methods, Tonsillar Neoplasms surgery
- Abstract
Objective: The purpose of this study was to evaluate the clinical usefulness of TORS and transoral robotic retropharyngeal lymph node (RPLN) dissection in tonsillar cancer patients with suspicious RPLN metastasis., Methods: From April 2008 to March 2014, 71 patients with tonsillar cancer underwent transoral robotic surgery and standard neck dissection at the Yonsei Head and Neck Cancer Center., Results: Three patients underwent transoral robotic ropharyngectomy with transoral robotic RPLN dissection because of suspicious RPLN metastasis. The mean age of the patients was 42 years (range, 31-50 years). There were no cases of wound infection or serious complications related to wound healing. Mild nasal regurgitation was observed during an oral diet immediately after surgery, but all patients spontaneously resolved without surgical treatment. There was no significant bleeding due to great vessel injury during surgery or swallowing difficulty due to cranial nerve IX injury., Conclusion: Although the oncologic stability and usefulness of this technique should be confirmed based on large-scale research, RPLN can be easily accessed and resected through our approach with less morbidity compared to the conventional surgical approach. In addition, because RPLN metastasis can be performed pathologically based on obtained specimens, it will be helpful to explore whether to perform adjuvant radiation.
- Published
- 2019
- Full Text
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95. Atypical Metastasis of p16-Positive Tonsillar Squamous Cell Carcinoma to the Pleura: A Case Report.
- Author
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LeRose CC and Ramirez CA
- Subjects
- Carcinoma, Squamous Cell diagnosis, Carcinoma, Squamous Cell pathology, Carcinoma, Squamous Cell virology, Fatal Outcome, Humans, Male, Middle Aged, Pleural Neoplasms diagnosis, Pleural Neoplasms pathology, Pleural Neoplasms virology, Tonsillar Neoplasms virology, Carcinoma, Squamous Cell secondary, Papillomavirus Infections complications, Pleural Neoplasms secondary, Tonsillar Neoplasms pathology
- Abstract
Incidence rates and patterns of distant metastases of head and neck malignancies are well documented in the literature, such that focused management strategies are routinely practiced in anticipation of their likely behavior. Head and neck tumors are known to most commonly metastasize to the lungs, skeletal system, and liver, generally within 2 years of definitive treatment and in the context of poor locoregional control of the primary lesion. Recent studies, however, have shown that human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (SCCa) tumors display different patterns of distant metastases than those traditionally described for head and neck HPV-negative SCCa tumors. This finding has substantial implications for how patients undergoing treatment of these cancers should be surveilled after therapy. This report describes a case of p16-positive tonsillar SCCa with metastasis to a highly unusual secondary site in the pleura to show an example of the unconventional patterns of distant metastases reported for HPV-positive oropharyngeal SCCa in the recent literature. We aim to provide a more thorough understanding of this case by discussing the pathogenesis of metastatic spread to the pleura and the clinical progression generally observed in patients with secondary pleural malignancy. This report goes on to investigate how behaviors of distant metastases exhibited by HPV-positive oropharyngeal SCCa differ from those of more conventionally described head and neck HPV-negative SCCa and the implications thereof for strategies of post-treatment surveillance of these tumors going forward., (Copyright © 2018 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)
- Published
- 2018
- Full Text
- View/download PDF
96. Lingual Tonsillectomy Likely Does Not Improve Outcomes for Squamous Cell Carcinoma of the Head and Neck From an Unknown Primary Site.
- Author
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Wray J, Amdur RJ, Christopherson KM, Morris CG, Dziegielewski PT, Boyce BJ, and Mendenhall WM
- Subjects
- Adult, Aged, Aged, 80 and over, Biopsy, Carcinoma, Squamous Cell surgery, Female, Follow-Up Studies, Head and Neck Neoplasms surgery, Humans, Male, Middle Aged, Neoplasms, Unknown Primary surgery, Palatine Tonsil surgery, Prognosis, Retrospective Studies, Survival Rate, Tonsillar Neoplasms surgery, Tonsillectomy, Carcinoma, Squamous Cell pathology, Head and Neck Neoplasms pathology, Neoplasms, Unknown Primary pathology, Palatine Tonsil pathology, Tonsillar Neoplasms pathology
- Abstract
Objective: Patients with mucosal squamous cell carcinoma (SCC) of the head and neck almost always have a primary site in the base of tongue or tonsillar fossa. Lingual tonsillectomy has recently been advocated as part of the diagnostic evaluation as opposed to directed biopsies of the base of tongue and thought to possibly result in an increased likelihood or cure. The purpose of this project is to determine whether this is probable., Materials and Methods: We reviewed the medical records of patients treated with primary radiotherapy (RT) between January 1983 and March 2013. The outcomes were compared following RT in consecutively treated patients with either T1-2 base of tongue or unknown primary (cancer of unknown primary) SCC with predominantly level 2 adenopathy., Results: At 10 years, there were no clinically significant differences in the 2 groups, in local control, regional control, freedom from distant metastases, disease-specific, or cause-specific survival. Overall survival at 10 years was improved with T1-2 base of tongue cancers but not for those with T0 N3 disease. The reasons for this are unclear., Conclusions: Tongue base biopsy (or lingual tonsillectomy) likely increases the probability of identifying an unknown primary in the base of tongue, but it does not improve outcome following RT for patients with cancer of unknown primary SCC with predominantly level 2 adenopathy.
- Published
- 2018
- Full Text
- View/download PDF
97. Characteristic Histological Findings of Asymptomatic EBV-associated Lymphoproliferative Disorders in Tonsils.
- Author
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Jamiyan T, Nakazato Y, Kuroda H, Kojima M, and Imai Y
- Subjects
- Adolescent, Adult, Child, Child, Preschool, Female, Humans, Male, Epstein-Barr Virus Infections metabolism, Epstein-Barr Virus Infections pathology, Herpesvirus 4, Human metabolism, Lymphoproliferative Disorders metabolism, Lymphoproliferative Disorders pathology, Lymphoproliferative Disorders virology, Palatine Tonsil metabolism, Palatine Tonsil pathology, Palatine Tonsil virology, Tonsillar Neoplasms metabolism, Tonsillar Neoplasms pathology, Tonsillar Neoplasms virology
- Abstract
Recently, an in situ hybridization (ISH) and immunohistochemical study demonstrated that Epstein-Barr virus (EBV) infection may be involved in tonsillar hypertrophy and recurrent tonsillitis in children and young adolescents. The present study was based on 630 consecutive specimens from tonsillectomies performed at the Dokkyo University School of Medicine between 2002 and May 2017. Clinical findings were obtained from hospital records. Histologically, a "pale clear zone" was characterized by hyperplastic germinal centers with ill-defined borders and interfollicular expansion. Immunohistologically, the majority of immunoblasts were CD20-positive, whereas medium to large lymphoid cells usually expressed CD3. Among 14 lesions, numerous EBV-encoded small RNA (EBER)-positive cells were detected in 10. In 7 of these 10 lesions, EBER-positive cells were detected in germinal centers as well as in the interfollicular area. Based on our results, the "pale clear zone" suggests asymptomatic EBV infection of the tonsil. The present study demonstrated that "pale clear zones" should be taken into consideration when diagnosing asymptomatic EBV-associated LPDs in the tonsils of children and young adolescents as well as in middle-aged patients.
- Published
- 2018
- Full Text
- View/download PDF
98. Malignant melanoma metastasizing to tonsil: A rare presentation.
- Author
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Babu G, Azariah MB, Nair PS, and James FV
- Subjects
- Aged, Humans, Male, Melanoma pathology, Melanoma surgery, Neoplasm Metastasis, Tonsillar Neoplasms pathology, Tonsillar Neoplasms secondary, Tonsillar Neoplasms surgery, Melanoma drug therapy, Tonsillar Neoplasms drug therapy
- Abstract
Malignant melanoma (MM) has a high potential of lymphatic and hematogeneous spread, and metastatic disease is always incurable with a high mortality. We present a rare phenomenon of MM metastasizing to the palatine tonsil., Competing Interests: There are no conflicts of interest
- Published
- 2018
- Full Text
- View/download PDF
99. Life threatening bleeding from an osteonecrosis of the jaw: Are bisphosphonates safe in irradiated head and neck cancer patients?
- Author
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Assi T, Chebib R, Lakiss S, and Kattan J
- Subjects
- Aged, Bone Density Conservation Agents adverse effects, Carcinoma, Squamous Cell pathology, Fatal Outcome, Hemorrhage pathology, Humans, Jaw Diseases etiology, Jaw Diseases pathology, Male, Osteonecrosis etiology, Osteonecrosis pathology, Tonsillar Neoplasms pathology, Carcinoma, Squamous Cell therapy, Chemoradiotherapy adverse effects, Diphosphonates adverse effects, Hemorrhage chemically induced, Jaw Diseases drug therapy, Osteonecrosis drug therapy, Tonsillar Neoplasms therapy
- Abstract
Osteonecrosis of the jaw is a significant complication secondary to radiation therapy or drug therapy, most commonly bisphosphonates. Safety data regarding the administration of bisphosphonates in bone metastatic head and neck cancer patients with history of jaw irradiation are almost non-existent. In this paper, we report the case of a Head and Neck (HNC) patient, with history of radiation therapy to the mandible region, treated with intravenous bisphosphonates for bone metastases that resulted in gross, life threatening mouth hemorrhage secondary to advanced, locally invasive ONJ.
- Published
- 2018
100. A case of tonsillar metastasis from breast cancer and literature review.
- Author
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Jiang Z, Yang Y, Li S, Pan Z, and Lan L
- Subjects
- Biomarkers, Tumor analysis, Biopsy, Breast Neoplasms drug therapy, Carcinoma, Ductal, Breast drug therapy, Carcinoma, Ductal, Breast pathology, Female, Humans, Middle Aged, Tonsillar Neoplasms drug therapy, Tonsillar Neoplasms pathology, Breast Neoplasms pathology, Carcinoma, Ductal, Breast secondary, Tonsillar Neoplasms secondary
- Published
- 2018
- Full Text
- View/download PDF
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