2003 Volume 43 Issue 4 Pages 319-324
Background. Metastasis of a tumor to the tonsil is a rare event. We report two cases of non-small cell lung cancer with tonsillar metastasis. Twenty-eight cases of primary lung cancer with tonsillar metastasis including these two cases that have been reported in Japan are also reviewed. Case 1. A 52-year-old-man complaining of dyspnea was referred to our hospital for further examination of chest abnormal shadow. He was diagnosed as having poorly differentiated squamous cell carcinoma in the left upper lobe of the lung, T4N2M0, stage IIIB. During radiotherapy, he complained pharyngalgia. A tumor was noted in the left palatine tonsil, the surface of which was covered with white crust. A histopathological examination resulted in the diagnosis of metastatic tonsillar tumor from lung cancer (poorly differentiated squamous cell carcinoma). Radiotherapy was markedly effective to the metastatic tonsillar tumor. He died due to progression of primary lesion 9 months after the diagnosis of tonsillar metastasis. Case 2. A 52-year-oldman complaining of pharyngalgia was referred to our hospital for further examination of an abnormal chest shadow and bilateral tonsillar tumors. Large cell carcinoma in the right upper lobe of the lung, T3NOM1, stage IV was diagnosed. Uneven tumors which were ulcerated and covered with white crust were revealed in the bilateral palatine tonsils. The histopathological examinations resulted in the diagnosis of metastatic tonsillar tumor from lung cancer (large cell carcinoma). Metastatic tonsillar tumors completely disappeared after systemic chemotherapy. Nine months after the diagnosis of tonsillar metastasis, he was still alive. Conclusion. We described two rare cases of non-small cell lung cancer with tonsillar metastasis.
