抄録
We report an unusual case of bilateral synchronous tonsillar carcinoma. A 48-year-old Japanese man admitted for a firm, growing left cervical mass. In the left tonsil, a firm mass was noted, but a macroscopically normal right tonsil was found. Magnetic resonance imaging (MRI) demonstrated a moderately enhanced tumor of the left tonsil. Multiple cervical lymphadenopathy was also seen in the left jugular chain. On positron emission tomography (PET) scan, the maximum standard uptake value (SUV) for the left tonsil mass was 11.3 and for the left cervical lymph node was 4.1. The maximum the right tonsil SUV was 4.5. Biopsy intraorally from the left tonsil yielded a histopathologically diagnosis of squamous cell carcinoma (SCC). Excisional biopsy from the right level II cervical node under general anesthesia, yielded a diagnosis of metastatic SCC. Biopsy was followed by bilateral neck dissection and bilateral tonsillectomy. The right tonsil did not have any tumor macroscopically, but the bilateral paratine tonsil showed microscopical SCC invasion with some keratinization. Post operative radiotherapy was conducted for the bilateral neck and both tonsillar fossa. When contralateral cervical SCC metastasis occurs in those with a primary head and neck lesion, synchronous contralateral head and neck cancer may also be present. So bilateral tonsillectomy is recommended in T1 or T2 tonsillar carcinoma with bilateral cervical SCC metastasis.
