updated by Piper Wenzel, BS May 2024
- Tonsillar squamous cell carcinoma makes up ~15-20% of all oropharynx squamous cell carcinomas in the US (Wang 2023)
- Symptoms may include difficulty swallowing, pain in throat/ear, lumps in the neck (Wang 2023)
- HPV infection, ethanol, and smoking are all risk factors for disease development (Williamson 2024)
- HPV-positive squamous cell carcinoma is more common in younger patients of both genders whereas HPV-negative squamous cell carcinoma is more common in older men who smoke (Williamson 2024)
- HPV-positive squamous cell carcinoma develops from the deep lymphoid tissue of tonsillar crypts; non-keratizining (Williamson 2024)
- HPV-negative squamous cell carcinoma arises from the oropharyngeal/tonsil epithelium; keratinizing dysplasia (Williamson 2024)
- 5-year overall survival has been reported to be 71% for HPV-positive tumors and 46% for HPV-negative (Williamson 2024)
- If untreated, may invade lateral pterygoid muscle, pterygoid plates, lateral nasopharynx, skull base, carotid encasement (Williamson 2024)
- 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)
References
Williamson AJ, Mullangi S, Gajra A. Tonsil Cancer. [Updated 2023 Sep 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537238/
Wang J, Li X, Niu D, Huang J, Ye E, Zhao Y, Yue S, Hou X, Wu J. Mortality patterns of patients with tonsillar squamous cell carcinoma: a population-based study. Front Endocrinol (Lausanne). 2023 Dec 7;14:1158593. doi: 10.3389/fendo.2023.1158593. PMID: 38130394; PMCID: PMC10733501.