Squamous Cell Carcinoma - Tonsil
- Epithelial tumors of epidermoid lineage arising in the oropharynx mucosa
- Most commonly noted as an enhacing mass with deep invasive margins
- Size at discovery is highly variable, from clinically inapparent to enormous exophytic mass
- CT findings: small masses may be indistinguishable from asymmetric tonsil, large lesions enhance with contrast, invade surrounding tissue and commonly show spread to level 2a internal jugular chain
- MR findings: isointense to muscle on T1, iso- to slightly hyperintense on T2, tumor enhancement on T1 post-contrast (fat-saturation highly recommended)
- Make certain to assess for perineural spread (especially CN V3)
- HPV infection, ethanol, and smoking are all risk factors for disease development
- Cervical lymphadenopathy is seen in 60% of presentations
- Most common in men over the age of 40
- Recurrence is most common cause of death and usually occurs within 24 months
- Metastasis occurs to lungs > bones > liver
