Tonsillar metastasis for small cell neuroendocrine lung carcinoma; a case report.

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We report a case of small cell endocrine lung carcinoma with metastasis to the palatine tonsil 9 months after resection of lung cancer. A 52-year-old man was admitted to our department with sudden bleeding from the throat. A tumor was noted in the right palatine tonsil the surface of which was swollen and uneven and covered partially with white crust. Biopsy was done, and the pathological diagnosis was metastatic tonsillar tumor from lung carcinoma. The right palatine tonsil and submandibular lymph gland were removed, and neck lymphnode dissection was performed. One of the cervical lymphnodes contained metastatic cancer tissue, but there was no evidence of direct invasion from it to the palatine tonsil. There have been only 18 cases reports of metastatic tonsillar tumors from lung cancer in the Japanese and English literature. There are some reasons for this : (1) lymphatic spread is hard to explain because of the lack of afferent lymphatics to the tonsils ; (2) the tonsils strong immune function protects it better than can other organs from invasion by tumor. The histological type was small cell carcinoma in 13 cases, large cell carcinoma in 3 cases, adenocarcinoma in 1 case and unknown type in 1 case. Our patient had the characteristic features of small cell neuroendocrine carcinoma. Unfortunately he died 9 months after tonsillectomy.
特定非営利活動法人日本呼吸器外科学会の論文