Occult Tonsil Carcinomas; Diagnostic Implications of a Tonsillectomy for Heat and Neck Malignancies of Unknown Origin.

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We report the case of an occult tonsil carcinoma diagnosed only after a tonsillectomy. A 55 year-old man with upper and midjugular lymph node metastases from an unknown primary tumor was referred to our hospital for treament. The search for the primary tumor required panendoscopy of the upper aerodigestive tract, with biopsies of suspicious lesions at the level of nasopharynx and tonsils, which yielded no detectable primary site. The patient then underwent an ipsilateral radical neck dissection and tonsillectomy. Subsequent histopathologic examination of the whole tonsil specimen revealed an occult tonsil carcinoma in one of the crypts.We conclude that an ipsilateral tonsillectomy is the only reliable screening method to rule out an occult malignancy of the tonsil, and should be performed in patients with upper or mid jugular lymph node metastases due to an unknown primary tumor.
耳鼻咽喉科臨床学会の論文