Leptomeningeal carcinomatosis from carcinoma of the palatine tonsil (original) (raw)
Related papers
Oral Surgery, 2020
Metastases account for only 0.8% of all tonsillar malignancies and the lung, breast, kidney and melanoma are the commonest primary sites. Metastasis of colorectal carcinoma to the palatine tonsil is rare. We report of a 73-year-old man who presented with metastatic colorectal carcinoma in the right tonsil as the first presentation; the primary colorectal adenocarcinoma was diagnosed retrospectively. On magnetic resonance imaging, a 3.45cm tumour was identified in the right oropharynx with associated lymphadenopathy. Tonsillectomy histology confirmed metastatic colorectal adenocarcinoma. On further imaging, an 8cm mass was identified in the sigmoid colon and a biopsy confirmed a poorly differentiated adenocarcinoma. The patient received 2 cycles of palliative chemotherapy but died 5 months following presentation. Literature review identified thirteen case reports in the English scientific literature and clinicopathological analysis of these is presented. The mean age was 55.21 years (age range-37 to 81) with male predominance. Half of the patients had a primary tumour in the rectum. Tonsillar involvement was either primary presentation or has been present at the time of diagnosis of primary colorectal tumour in five cases; in all of these, the differentiation of tumour was poor and 3/5 had signet ring morphology. These tumours showed poor prognosis and the life expectancy was 6 to 15 months irrespective of the type of treatment. This case highlights the importance of considering metastatic carcinoma in the differential diagnosis even at unlikely sites.
Leptomeningeal Metastases in Nasopharyngeal Carcinoma: A Rare Case Report and a Review of Literature
2021
Introduction: The most common sites for distant nasopharyngeal carcinoma metastases are the bone, lung, and liver. Leptomeningeal metastases LM in undifferentiated nasopharyngeal carcinoma are rare. Case and outcomes: We present a case report of a 36 years old patient treated initially for undifferentiated nasopharyngeal carcinoma (T2N3M0, stage III of AJCC 7th edition) by association of chemotherapy and radiotherapy. Two years and half later, the patient developed a frontal leptomeningeal metastasis in association with subcutaneous and left parotid relapses on MRI. The patient was treated by resection of the leptomeningeal and subcutaneous lesions. These masses turned out to be an undifferentiated carcinoma consistent with nasopharyngeal carcinoma metastasis. The patient refused parotidectomy and adjuvant radiotherapy of leptomeningeal metastasis was performed. She is now being treated with chemotherapy. Discussion: Leptomeningeal metastases from nasopharyngeal carcinoma are rare a...
Multiple cutaneous metastases in a patient of carcinoma tonsil – Report of a rare case
Journal of the Egyptian National Cancer Institute, 2016
Carcinoma tonsil with visceral metastasis is a rare entity, and cutaneous metastasis is seen even more infrequently. We present a case of a 55-year-old male with carcinoma tonsil having received concurrent chemo radiotherapy, presenting with multiple cutaneous metastases to the scalp and thigh. To the best of our knowledge, till date only two similar cases of carcinoma tonsil with cutaneous metastasis have been reported in the English literature.
Tonsillar Metastasis of Gastric Carcinoma: A Case Report and Literature Review
Head and neck cancer research, 2019
Tonsillar metastasis of gastric cancer is very rare. We report a case of tonsillar metastasis from signet ring cell gastric carcinoma. We present the case of 66-year-old man who was treated for gastric cancer in 2014. After 2 years and 3 months, the patient developed a loco-regional recurrence. He underwent surgery and post-operative chemotherapy. During the follow-up, 21 months after the recurrence, the patient developed pharyngeal discomfort. A mass of 4 cm was observed in the palatine tonsil with multiple cutanoeus metastases. It was diagnosed as a metastasis from gastric cancer. The patient died one month later.
Metastasis to the thyroid gland from a tonsil squamous cell carcinoma
AME case reports, 2018
We present a case of rare metastasis of tonsil squamous cell carcinoma to the thyroid gland, after 2 years of treatment without recurrence at the primary site. The patient had incidental finding of a nodule in the left lobe of the thyroid gland during a screening scan for his previous tonsil squamous cell carcinoma that was treated surgically 2 years ago. The patient was completely asymptomatic with normal thyroid function tests. After further investigations and discussion in the MDT meeting, the patient underwent left thyroid lobectomy as a definitive treatment for his thyroid metastasis.
A Merkel-Cell Carcinoma Metastatic to the Tonsil: A Case Report and Review of the Literature
Journal of Oral and Maxillofacial Surgery, 2013
Metastatic tumors to the palatine tonsils are extremely rare, with nearly 100 cases reported. Only 3 cases of Merkel cell carcinoma of the skin metastasizing to the palatine tonsil have been reported. We present the interesting case of a 61-year-old man with an enlargement of the left palatine tonsil that caused a moderate narrowing of the oropharynx. Three years previously he had been treated for Merkel cell carcinoma (MCC) on skin of his left shoulder. A tonsillectomy followed by palatoplasty was performed. Immunohistochemical staining demonstrated a pronounced reaction for cytokeratin 20, chromogranin, and CD56 histodiagnostic markers. Immunohistochemical studies are useful diagnostic tools in the establishment of the diagnosis of MCC. Treatment includes wide local surgical excision of the tumor, radiotherapy, and chemotherapy. Considering the aggressiveness of MCC, an early diagnosis is critical to enable the choice of adequate therapy at an early stage. Ó Merkel cells are found in the skin and in those parts of the mucosa derived from ectoderma. 1 These cells are the origin of a rare, malignant, neuroendocrine tumor that occurs predominantly in the sun-exposed areas of the skin termed ''Merkel cell carcinoma'' (MCC). 2,3 Local recurrence and regional or distant metastases generally develop within a short period. Distant metastases usually develop in the lung, abdominal viscera, bones, and brain. 4,5 Oropharyngeal metastasis is very
Radiotherapy as Initial Treatment for Carcinomas of Tonsillar Region
Tumori Journal, 1982
For this study we have reviewed 186 carcinomas of the tonsillar region, i.e., the lateral wall of the oropharynx, treated from January 1959 to December 1973 at this Institute. In 148 patients (79.6%) the primary tumor and the lymphatic areas were treated with 60Co-teletherapy (TCT). In 15 cases (8.1%) the primary lesion was removed by transoral surgery, followed by irradiation of the tonsillar region and lymphatic areas with TCT. In 23 patients (12.3%) the primary tumor was treated with interstitial curietherapy, after which a radical homolateral neck dissection was performed on 10 of them; the neck was not treated in the remaining 13 cases, initially N0. As far as the cases initially treated with TCT alone are concerned, disease-free survival at 5 years was 42.5% for T1 cases and under 30% for T2, T3, whereas it was only 6.5% for T4. The most frequent failure cause of TCT was local relapse, isolated or associated with a nodal relapse. Local failures were nearly always central. On t...
A Rare Case of Colonic Metastases From Tonsillar Carcinoma: Case Report and Review of Literature
World journal of oncology, 2018
The incidence of tonsillar cancer has increased by four times in the United States over the last few decades likely due to recent increase in human papilloma virus (HPV) infections. The stage of the tumor predicts likelihood of metastasis, with advanced stages associated with higher chances of metastasis. The squamous cell carcinomas (SCCs) of the head and neck commonly metastasize to the lung, bone and liver in descending order. Tonsillar cancer rarely involves the small bowel and our review of the literature did not reveal any reported case of metastasis to the colon/large bowel. Our patient had locally metastatic tonsillar cancer, treated with partial pharyngectomy and selective neck dissection but later developed several bone and colonic metastases concurrently, likely secondary to hematogeneous dissemination after a few months of therapy. To the best of our knowledge, large bowel metastasis from head and neck SCC has never been reported in the literature. In these patients pres...