Hypernephroma Metastatic to the Palatine Tonsils

Brownson, Richmond Jay; Jaques, William E.; LaMonte, Samuel E.; Zollinger, William

doi:10.1177/000348947908800215

Cited by 60 publications

(84 citation statements)

References 20 publications

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“…In patients with metastatic tonsillar involvement, lung cancer has been reported as the site of primary disease in 24 cases thus far, with small cell lung cancer being the dominant histology (9). Metastatic involvement of the tonsils is associated with a poor prognosis and survival following the development of tonsillar metastases is approximately 9 months, independent of the histology of the primary tumor (10).…”

Section: Discussionmentioning

confidence: 99%

Hepatoid adenocarcinoma of the lung metastasizing to the tonsil

Valle

Thomas

Kim

et al. 2017

Molecular and Clinical Oncology

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Abstract. Hepatoid adenocarcinoma (HAC) is a rare tumor that typically originates in gastrointestinal tissue, such as the stomach, but can also occasionally originate in the lung. The majority of HACs express α-fetoprotein (AFP) on tumor cells, and serum AFP can be used as a marker of response to treatment or disease progression. HAC has a poor prognosis, although early diagnosis and aggressive treatment can result in long-term survival. To the best of our knowledge, this is the first reported case of HAC metastasizing to the tonsil. Irradiation using intensity-modulated radiation therapy (IMRT) to 30 Gray (Gy) achieved a significant, and durable tumor response. IMRT can be considered for local control of HAC at other metastatic sites of disease. IntroductionHepatoid adenocarcinoma (HAC) is a rare α-fetoprotein (AFP)-producing tumor that morphologically resembles hepatocellular carcinoma. Tumor cells have eosinophilic cytoplasm, centrally located nuclei proliferating in a trabecular pattern, and express AFP, HepPar1, HEA125 and MOC31 (1,2). The lung is the primary site in approximately 5% of cases of HAC (1). HAC metastasis to the brain, liver, adrenal gland, lymph nodes and bones has been previously described (1). The prognosis in patients with unresectable disease is generally poor with overall survival of 6 to 11 months (3).In the present study, we report, to the best of our knowledge, the first case of primary lung HAC metastasizing to the tonsil.Wide surgical excision, chemotherapy, and radiation therapy (RT) have been used to treat oropharyngeal metastases from solid tumors (4). However, the role of RT for tonsillar metastases has not been previously described. The potential benefits of palliative RT in patients with lung cancer metastasis to the tonsils include mitigation of asphyxiation risk, durable remission, and an improvement in survival (5-7). Thus, RT should be considered a potentially effective treatment for tonsillar metastasis albeit tonsillar metastases portend a poor prognosis with a high likelihood of disease at other sites (5). Case reportA 61-year-old male presenting with left-sided chest pain due to malignant pleural effusion was diagnosed with stage IVA HAC of the lung (Fig. 1). Despite front-line chemotherapy with cisplatin and pemetrexed, he experienced multiple recurrences with metastasis to the lungs, liver, adrenal gland, and spine and received four additional lines of chemotherapy. Forty-five months after diagnosis, the patient complained of a foreign-body sensation in his throat that caused intermittent gagging and a mass was identified in the left palatine tonsillar fossa ( Fig. 2A). He had no systemic complaints except intermittent fatigue and mid-back pain from a metastatic thoracic spine lesion previously treated with RT. Magnetic resonance imaging (MRI) of the neck showed asymmetry of the tonsils (left larger than right), no direct invasion of the tonsillar mass into deeper structures and no cervical lymphadenopathy (Fig. 2B). A fluorodeoxyglucose positron emission tomography ...

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Section: Discussionmentioning

confidence: 99%

Hepatoid adenocarcinoma of the lung metastasizing to the tonsil

Valle

Thomas

Kim

et al. 2017

Molecular and Clinical Oncology

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“…Our case was a 53-year old male patient with primary ascending colon cancer. Metastatic palatine tonsil cancer is often unilateral, with the left side more commonly involved than the right side [20] . Lymphatic routes have been proposed as the possible pathways of metastatic palatine tonsil cancer from colorectal cancer.…”

Section: Discussionmentioning

confidence: 99%

Ascending colon adenocarcinoma with tonsillar metastasis: A case report and review of the literature

Sheng

Zhang²,

Xu³

et al. 2008

WJG

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Metastatic palatine tonsil cancer is extremely rare, with nearly 100 such tumors reported in the English literature. The prognosis of metastatic palatine tonsil cancer is poor. A 53-year-old man presented with painless left palatine tonsillar swelling and a cervical mass following right hemicolectomy for an ascending colon adenocarcinoma. Physical examination showed an ulcerated mass located on the upper pole of the left palatine tonsil. A punch biopsy was taken for histological examination which showed a moderatelydifferentiated adenocarcinoma. The patient was treated with palliative radiotherapy and chemotherapy. He was still alive when we wrote this paper. Our case shows that immunohistochemical diagnosis of metastatic palatine tonsil cancer is essential.

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“…Tonsillar metastasis can be bilateral or unilateral depending on the nature of the primary neoplasm. The prognosis for patients with tonsillar metastasis is rather poor 6 . In this report, we present a case of a phyllodes tumor that metastasized to the tonsil; we have included the clinical features and pathological findings.…”

Section: Introductionmentioning

confidence: 99%

Phyllodes tumor metastasis to the tonsil with synchronous undifferentiated carcinoma

Sano

Sato

Watanabe³

et al. 2014

International Journal of Surgery Case Reports

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INTRODUCTIONBreast tumor metastasis to the tonsil is extremely rare.PRESENTATION OF CASEA 54-year-old woman underwent resection of a breast malignant phyllodes tumor and later presented with metastasis to the lung and the left tonsil. She underwent left lower lobectomy and resection of the left tonsillar tumor. She subsequently developed undifferentiated carcinoma of the right tonsil. She underwent resection of the right tonsillar tumor and chemotherapy was started. The central venous catheter became infected with methicillin-resistant Staphylococcus aureus. Finally, she died.DISCUSSIONTo the best of our knowledge, this is the first reported case of a phyllodes tumor metastasizing to the tonsil. Furthermore, morphological and immunohistochemical study revealed that the right tonsillar tumor was irrelevant to the phyllodes tumors.CONCLUSIONWe report a case of phyllodes tumor metastasis to the left tonsil which developed undifferentiated carcinoma in the other side of tonsil later. Breast tumor metastasis to the tonsil is rare but it should be considered as a possible diagnosis.

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Hypernephroma Metastatic to the Palatine Tonsils

Cited by 60 publications

References 20 publications

Hepatoid adenocarcinoma of the lung metastasizing to the tonsil

Hepatoid adenocarcinoma of the lung metastasizing to the tonsil

Ascending colon adenocarcinoma with tonsillar metastasis: A case report and review of the literature

Phyllodes tumor metastasis to the tonsil with synchronous undifferentiated carcinoma

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