The purpose of this systematic review and meta-analysis was to identify the prevalence of synchronous contralateral tonsil carcinoma (SCTC) amongst patients with tonsil carcinoma or head and neck squamous cell carcinoma of unknown primary (HNSCCUP). Thirteen retrospective studies, comprising 2623 patients, were analysed, revealing an overall pooled SCTC prevalence of 4%, rising to 10% in HNSCCUP cases. HPV/p16 positivity was associated with SCTC prevalence of 3%, while HPV/p16 negativity was greater at 8%. Clinical or imaging evaluations often missed SCTC preoperatively, emphasising the importance of contralateral tonsillectomy. Morbidity varied among patients undergoing contralateral tonsillectomy. The prevalence of SCTC is significant in cases of HNSCCUP and tonsil malignancy, emphasising the importance of informed discussions regarding contralateral tonsillectomy. Tailored approaches considering individual patient and tumour characteristics are crucial, with contralateral tonsillectomy generally warranted in HNSCCUP. Further research, including prospective studies with standardised protocols, is needed to improve the understanding and management of SCTC, specifically the clinical significance of occult SCTC.
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The purpose of this systematic review and meta-analysis was to identify the prevalence of synchronous contralateral tonsil carcinoma (SCTC) amongst patients with tonsil carcinoma or head and neck squamous cell carcinoma of unknown primary (HNSCCUP). Thirteen retrospective studies, comprising 2623 patients, were analysed, revealing an overall pooled SCTC prevalence of 4%, rising to 10% in HNSCCUP cases. HPV/p16 positivity was associated with SCTC prevalence of 3%, while HPV/p16 negativity was greater at 8%.
View Article and Find Full Text PDFInvestigations for Suspected Head and Neck Squamous Cell Carcinoma of Unknown Primary (HNSCCUP): A National Cohort Study.
Clin Otolaryngol
January 2025
Head and Neck Unit, The Royal Marsden Hospital, London, UK.
Objectives: Head and neck squamous cell carcinoma from unknown primary (HNSCCUP) is a rare and challenging condition. This study aimed to investigate the diagnostic pathways of suspected HNSCCUP patients in the United Kingdom.
Methods: A retrospective observational cohort study was conducted, over 5 years from January 2015, in UK Head and Neck centres of consecutive adults undergoing 18F-Fluorodeoxyglucose-PET-CT (PET-CT) within 3 months of diagnosis with metastatic cervical squamous cell carcinoma.
Malignant Abrikossoff's Tumour of the Tonsil - A Case Report of a Rare Entity.
Ann Maxillofac Surg
May 2024
Department of Medical and Surgical Sciences, Alma Mater Studiorum - Università di Bologna, Italy.
Rationale: This study aimed to report an uncommon site of origin of a rare head-and-neck cancer, namely malignant granular cell tumour.
Patient Concerns: An 89-year-old female patient complained of persistent pharyngodynia and odynophagia for two months.
Diagnosis: Upon clinical examination, the right palatine tonsil was larger and palpably firmer than the contralateral.
The Effect of Tranexamic Acid Local Injection on Bleeding during and after Tonsillectomy: A Double-Blind Randomized Placebo-Controlled Trial.
World J Plast Surg
January 2023
Department of Otorhinolaryngology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Background: Tonsillectomy-related bleeding is one of the most prevalent and potentially fatal complications of this common surgical procedure. We aimed to assess the effect of tranexamic acid (TXA) local injection on bleeding during and after tonsillectomy.
Methods: This double-blind, randomized placebo-controlled trial included 20 candidates for tonsillectomy referred to Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran, in 2022.
Step Serial Sectioning in Head and Neck Squamous Cell Carcinoma of Unknown Primary.
JAMA Otolaryngol Head Neck Surg
February 2024
Head and Neck Unit, The Royal Marsden National Health Service Foundation Trust, London, England.
Importance: Patients with suspected head and neck squamous cell carcinoma of unknown primary (HNSCCUP) may undergo tonsillectomy and tongue base mucosectomy (TBM) to help identify clinicoradiologically occult primary disease. It is hypothesized that when these diagnostic specimens are analyzed, conventional histopathological (CH) techniques risk missing small primary tumors that may be hidden in the tissue blocks.
Objective: To establish the outcomes of a step serial sectioning (SSS) histopathological technique vs CH when analyzing diagnostic tissue specimens from TBM and tonsillectomy performed for HNSCCUP.
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