The treatment of tonsillar squamous cell carcinoma at Hue Central Hospital

Objective: To explore some clinical features, treatment selection and middle-term outcomes of patients with tonsillar squamous cell carcinoma at Hue Central Hospital. Methods: A prospective study was conducted in a total of 29 patients with squamous cell carcinoma of the tonsil who had been diagnosed and treated at Hue Central Hospital from 1/2018 to 6/2020. Results: Patients aged over 50 years old were the most seen (accounted for 69%). The mean of age was 57.1 ± 12.8, the ratio of male and female was 1.4/1. The major reason was odynophagia (accounted for 69%). Patients in advanced stage were most often. The cumulative survival rate at 24 months and advanced-stage were 85,7%, 63,6% respectively. All patients with primary surgery followed by adjuvant radiotherapy were still alive in follow-up period, 30 months. The cumulative survival rate of the palliative treatment group at 12 months was 21.9%. Conclusion: Primary surgery followed by adjuvant radiotherapy is an effective treatment of squamous cell carcinoma of the tonsil.

Synchronous HPV positive bilateral palatine tonsillar squamous cell carcinoma – Brief review of current literature on the role of magnetic resonance imaging

Synchronous bilateral palatine tonsillar Squamous Cell Carcinoma (SCC) is a rare presentation and less than 10 cases of Human Papillomavirus (HPV) mediated synchronous bilateral palatine tonsillar SCC has been reported. We report case of a patient who presents with a painless left sided neck swelling and was subsequently diagnosed by imaging and histopathology with bilateral Squamous Cell Carcinoma (SCC) of the palatine tonsil and cervical nodal metastasis. Due to its excellent soft tissue/tumor contrast resolution, Magnetic Resonance Imaging (MRI) is the preferred imaging modality for initial staging. Improved sensitivity for the detection of synchronous tumors can be achieved by Positron Emission Tomography (PET)/ Computed Tomography (CT) examination. Due to the rare nature of this pathology, no specific treatment guideline has been provided by National Comprehensive Cancer Network (NCCN). Treatment options available include bilateral Transoral Robotic Surgery (TORS) radical tonsillectomy combined with bilateral neck dissection with adjuvant radiotherapy or chemoradiotherapy and/or upfront concurrent chemoradiotherapy.

Isolated pituitary fossa metastasis from a primary tonsillar squamous cell carcinoma: case report

ObjectiveThis paper presents a case of an isolated pituitary fossa metastasis on a background of a previously treated tonsillar squamous cell carcinoma.Case reportA 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.ConclusionThis 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.