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Viruses Mar 2015In 2007, human papillomavirus (HPV) type 16 was recognized as a risk factor by the International Agency for Research on Cancer, for oropharyngeal squamous cell carcinoma... (Review)
Review
In 2007, human papillomavirus (HPV) type 16 was recognized as a risk factor by the International Agency for Research on Cancer, for oropharyngeal squamous cell carcinoma (OSCC), where tonsillar and base of tongue cancer (TSCC and BOTSCC) dominate. Furthermore, patients with HPV-positive TSCC and BOTSCC, had a much better clinical outcome than those with corresponding HPV-negative cancer and other head and neck cancer. More specifically, survival was around 80% for HPV-positive TSCC and BOTSCC vs. 40% five-year disease free survival, for the corresponding HPV-negative tumors with conventional radiotherapy and surgery, while this could not be observed for HPV-positive OSCC at other sites. In addition, the past 20-40 years in many Western Countries, the incidence of HPV-positive TSCC and BOTSCC has risen, and >70% are men. This has resulted in a relative increase of patients with HPV-positive TSCC and BOTSCC that may not need the intensified chemo-radiotherapy (with many more severe debilitating side effects) often given today to patients with head and neck cancer. However, before tapering therapy, one needs to enable selection of patients for such treatment, by identifying clinical and molecular markers that together with HPV-positive status will better predict patient prognosis and response to therapy. To conclude, there is a new increasing group of patients with HPV-positive TSCC and BOTSCC with good clinical outcome, where options for better-tailored therapy are needed. For prevention, it would be of benefit to vaccinate both girls and boys against HPV16 infection. For potential future screening the ways to do so need optimizing.
Topics: Carcinoma, Squamous Cell; Humans; Papillomaviridae; Papillomavirus Infections; Survival Analysis; Tongue Neoplasms; Tonsillar Neoplasms; Treatment Outcome
PubMed: 25803099
DOI: 10.3390/v7031332 -
Viruses May 2021The incidence of Human-papillomavirus-positive (HPV) tonsillar and base-of-tongue squamous cell carcinoma (TSCC and BOTSCC, respectively) is increasing epidemically, but... (Review)
Review
The incidence of Human-papillomavirus-positive (HPV) tonsillar and base-of-tongue squamous cell carcinoma (TSCC and BOTSCC, respectively) is increasing epidemically, but they have better prognosis than equivalent HPV-negative (HPV) cancers, with roughly 80% vs. 50% 3-year disease-free survival, respectively. The majority of HPV TSCC and BOTSCC patients therefore most likely do not require the intensified chemoradiotherapy given today to head and neck cancer patients and would with de-escalated therapy avoid several severe side effects. Moreover, for those with poor prognosis, survival has not improved, so better-tailored alternatives are urgently needed. In line with refined personalized medicine, recent studies have focused on identifying predictive markers and driver cancer genes useful for better stratifying patient treatment as well as for targeted therapy. This review presents some of these endeavors and briefly describes some recent experimental progress and some clinical trials with targeted therapy.
Topics: Biomarkers, Tumor; Carcinoma, Squamous Cell; Cell Transformation, Neoplastic; Cell Transformation, Viral; Gene Expression; Humans; Immunohistochemistry; Molecular Targeted Therapy; Mutation; Oncogenes; Papillomavirus Infections; Prognosis; Protein Kinase Inhibitors; Tongue Neoplasms; Tonsillar Neoplasms; Treatment Outcome
PubMed: 34069114
DOI: 10.3390/v13050910 -
Veterinary and Comparative Oncology Dec 2020Tonsillar metastasis from distant primary tumours has not been described in dogs, and reports are rare in humans. The aims of this study were to determine whether tumour...
Tonsillar metastasis from distant primary tumours has not been described in dogs, and reports are rare in humans. The aims of this study were to determine whether tumour metastasis occurs to the canine palatine tonsils and evaluate whether afferent lymphatics drain to the palatine tonsils via skull indirect computed tomography lymphangiography (ICTL). Retrospective review of the diagnostic laboratory tonsillar histopathology submissions was performed. ICTL studies (n = 53) were retrospectively reviewed by a single radiologist. Of 882 total tonsil histopathology samples, 492 (56%) were considered neoplastic, with 8% of them benign. Of the primary malignant neoplasms of the tonsil, squamous cell carcinoma (55%), lymphoma (17%) and melanoma (12%) were most common. Tonsillar metastasis was confirmed in 41 cases; histopathologic evaluation revealed melanoma (25), carcinoma (10), hemangiosarcoma (2) and one each of fibrosarcoma, malignant histiocytosis, basal cell tumour and undifferentiated sarcoma. A total of 53 tonsillar melanoma cases were identified, of which 25 represented metastasis from a known distant primary tumour and 28 were solely tonsillar, with 9 of these cases having concurrent lymph node metastasis. No ICTL cases had lymphatic contrast drainage to the palatine tonsil. The palatine tonsil is an important site of metastasis for a variety of primary tumour types from many locations. ICTL did not reveal lymphatics draining to the palatine tonsil, which is highly supportive of hematogenous route of metastasis to the tonsil. Tonsillar metastasis may be more common than previously thought. It is recommended to perform a thorough oral examination, including the tonsils, for all oral tumours and melanoma cases.
Topics: Animals; Colorado; Dog Diseases; Dogs; Neoplasms; Palatine Tonsil; Retrospective Studies; Tonsillar Neoplasms
PubMed: 32352191
DOI: 10.1111/vco.12604 -
Archives of Pathology & Laboratory... Dec 2013Lymphangioma of the palatine tonsil is a rare, benign lesion that presents as a tonsillar outgrowth and causes symptoms related to irritation and airway obstruction.... (Review)
Review
Lymphangioma of the palatine tonsil is a rare, benign lesion that presents as a tonsillar outgrowth and causes symptoms related to irritation and airway obstruction. Histologically, the mass has abundant dilated lymphatic channels amid a fibrous stroma with lymphoid and adipose elements. There are several theories regarding the pathogenesis of these lesions, and the appropriate diagnostic classification is controversial. Because a lymphangioma may resemble a true neoplasm of the palatine tonsil clinically, the lesion must be removed for accurate histologic diagnosis and to rule out malignancy. Lymphangioma of the palatine tonsil is treated with surgical excision and has no recurrence once completely resected.
Topics: Diagnosis, Differential; Humans; Incidence; Lymphangioma; Neoplasm Recurrence, Local; Palatine Tonsil; Pharyngeal Neoplasms; Tonsillectomy
PubMed: 24283866
DOI: 10.5858/arpa.2012-0678-RS -
Proceedings of the Royal Society of... Jun 1968
Topics: Animals; Diagnosis, Differential; Dogs; Female; Humans; Male; Nose; Nose Diseases; Otorhinolaryngologic Diseases; Pharyngeal Diseases; Respiration; Sleep; Sleep Deprivation; Stress, Physiological; Tonsillar Neoplasms
PubMed: 5662208
DOI: No ID Found -
Iranian Journal of Otorhinolaryngology Mar 2018Lymphoma is a common malignant tumor of the head and neck occurring during childhood. Early diagnosis is very important in terms of prognosis in patients with tonsillar... (Review)
Review
INTRODUCTION
Lymphoma is a common malignant tumor of the head and neck occurring during childhood. Early diagnosis is very important in terms of prognosis in patients with tonsillar lymphoma.Our objective was to evaluate the clinical manifestations of pediatric tonsillar lymphoma according to different age groups.
MATERIALS AND METHODS
A systematic review of available English, Spanish, or Portuguese literature from January 1996 to June 2012 was performedin the BIREME, Cochrane, IBECS, Lilacs, PubMed/Medline, SCIELO, and Scopus databases, using "tonsillar lymphoma" and "children" as keywords. Inclusion criteria were pediatric case reports, patients aged up to 18 years, and information on clinical features at the time of diagnosis.
RESULTS
Out of 87 identified publications, 13 articles were selected describing 53 patients. Tonsillar asymmetry was the most common sign. Snoring is a common sign in patients aged under 5 years; clinical lymphadenopathy is frequent among patients aged between 6 and 10 years; and dysphagia is a common sign in patients between 11 and 18 years of age. Burkitt's lymphoma is the most common form among all ages studied, followed by B-cell lymphoma.
CONCLUSION
Clinical manifestations differ according to age group. However, tonsillar asymmetry is the most frequent sign regardless of age group.
PubMed: 29594072
DOI: No ID Found -
European Annals of Otorhinolaryngology,... Dec 2017Based on a review of the indexed scientific medical literature, the authors document the key technical points, the errors to avoid, the limitations, indications and main...
Based on a review of the indexed scientific medical literature, the authors document the key technical points, the errors to avoid, the limitations, indications and main oncologic and functional results when performing transoral lateral oropharyngectomy in cancer originating from the tonsillar region.
Topics: Carcinoma, Squamous Cell; Humans; Mouth; Natural Orifice Endoscopic Surgery; Oropharynx; Tonsillar Neoplasms; Tonsillectomy; Treatment Outcome
PubMed: 28669807
DOI: 10.1016/j.anorl.2017.06.002 -
Molecular and Clinical Oncology Sep 2017In order to confirm the inverse correlation between secretory leucocyte protease inhibitor (SLPI) expression, and human papillomavirus (HPV) infection previously...
In order to confirm the inverse correlation between secretory leucocyte protease inhibitor (SLPI) expression, and human papillomavirus (HPV) infection previously observed in head and neck squamous-cell carcinoma, the present study retrospectively investigated the association between SLPI and Annexin A2 (AnxA2) expression, and HPV status in non-neoplastic chronic tonsillitis (n=118), and tonsillar hyperplasia (n=96) tissue. We hypothesised that smoking induces the upregulation of SLPI, resulting in reduced binding of HPV to AnxA2, a known modulator of HPV entry into the cell. SLPI and cyclin-dependent kinase inhibitor 2A (p16) protein expression was measured using immunohistochemistry in 214 specimens; SLPI and AnxA2 gene expression was measured using reverse transcription-quantitative polymerase chain reaction in 213 cases; and DNA was isolated from all the specimens to determine HPV status. The association between the results of the aforementioned analyses and the smoking habits of patients was analysed. The samples were HPV-negative. p16 expression demonstrated moderate and strong staining in 38, and 0 cases, respectively. SLPI expression presented negative, weak and moderate signals in 163, 45, and 6 cases, respectively. A positive correlation was identified between smoking and SLPI (P=0.0001). Gene expression analysis (n=213) revealed that smoking (n=48) resulted in a significant increase in SLPI and AnxA2 expression. A significant positive correlation between AnxA2 and SLPI, indicating a surplus of AnxA2 in relation to SLPI, was exclusively identified in non-smokers. The data demonstrated that smoking results in increased SLPI and AnxA2 expression also in non-neoplastic tonsillar tissue. The observed surplus of AnxA2 in relation to SLPI identified exclusively in the tonsillar tissue of non-smokers indicates a higher possibility of a successful HPV infection of the tonsillar tissue of non-smokers, given the properties of AnxA2 to function as an infection modulator.
PubMed: 28811900
DOI: 10.3892/mco.2017.1343 -
Infectious Agents and Cancer 2017The incidence of synchronous bilateral tonsil carcinoma seems to be underreported. For adequate oncologic treatment, it is mandatory to remove all primaries to prevent... (Review)
Review
BACKGROUND
The incidence of synchronous bilateral tonsil carcinoma seems to be underreported. For adequate oncologic treatment, it is mandatory to remove all primaries to prevent recurrence or metachronic disease. The purpose of this manuscript is to provide a comprehensive review on this topic and to emphasize the need of bilateral tonsillectomy in cases of cancer of unknown primary (CUP) as well as in the case of a unilateral tonsillar carcinoma.
MATERIAL AND METHODS
A systematic review of the literature was performed for "bilateral tonsillar neoplasm", "synchronous cancer of the oropharynx" and "cancer of unknown primary in head and neck".
RESULTS
We present a clinical case with bilateral tonsillar carcinoma in initially suggested cancer of unknown primary. Clinically, both tonsillar sites were unsuspicious, but in PET/CT an ipsilateral enhancement of the tonsil area was detected. The pathological work up of bilateral tonsillectomy specimens revealed bilateral squamous cell carcinoma with HPV-type 16 positivity. The review of the literature revealed 29 cases of bilateral tonsil cancer.
CONCLUSION
The handling of tonsillar tissue in the frame of panendoscopy in the case of CUP is still controversial. We recommend a bilateral tonsillectomy as a routine procedure for cancer of unknown primary as well as unilateral tonsillar carcinoma. Herewith the detrimental consequences of occult metachronous contralateral tonsillar carcinoma can be prevented.
PubMed: 28670333
DOI: 10.1186/s13027-017-0146-5 -
Radiologic Clinics of North America Sep 1998Imaging of the oral cavity and pharynx often is required in three settings: assessment of an inflammatory mass in association with odontogenic, tonsillar, or pharyngeal... (Review)
Review
Imaging of the oral cavity and pharynx often is required in three settings: assessment of an inflammatory mass in association with odontogenic, tonsillar, or pharyngeal infections; determination of the cause of a submucosal mass; and staging of squamous-cell carcinomas. Spread of infection from the oral cavity and pharynx can lead to abscesses in the masticatory space, the retropharyngeal compartment, and in a parapharyngeal location. Submucosal masses include congenital cysts (thyroglossal and dermoid), benign neoplasms (hemangioma, schwannomas, pleomorphic adenomas juvenile angiofibromas), inflammatory cysts (mucous retention cysts, ranulas), and pseudotumors (osteophytes, carotid arteries). Staging of squamous-cell carcinomas must focus on deep invasion, spread to the brain, nerves, mandible, prevertebral muscle, and pre-epiglottic fat.
Topics: Abscess; Bacterial Infections; Carcinoma, Squamous Cell; Cysts; Diagnostic Imaging; Focal Infection; Humans; Mouth; Mouth Diseases; Mouth Neoplasms; Neoplasm Invasiveness; Neoplasm Staging; Palatine Tonsil; Pharyngeal Diseases; Pharyngeal Neoplasms; Pharynx; Tooth Diseases
PubMed: 9747196
DOI: 10.1016/s0033-8389(05)70071-3