Management of tonsil cancer

✍ Scribed by Carol R. Bradford; Neal Futran; Glenn Peters

• Publisher: John Wiley and Sons
• Year: 1999
• Tongue: English
• Weight: 79 KB
• Volume: 21
• Category: Article
• ISSN: 1043-3074
• DOI: 10.1002/(sici)1097-0347(199910)21:7<657::aid-hed11>3.0.co;2-6

✦ Synopsis

A 43-year old man is examined for evaluation of a persistent, right-sided sore throat for 4 months, and a painless, slowly enlarging right neck mass for 3 months. On further questioning, he has right otalgia, but denies dysphagia, odynophagia, hemoptysis, hoarseness, or weight loss. He has a 40 pack/year smoking history, but is otherwise in good health.

Physical examination reveals a 3 cm × 3 cm exophytic mass involving the right tonsillar fossa and posterior tonsillar pillar. There is no trismus, the tongue base and soft palate are not involved, and his teeth are in good repair. The remainder of the head and neck examination is remarkable only for a firm, freely mobile 4 cm × 4 cm right level II lymph node.

A chest radiograph is normal, and a neck CT is shown in Figure 1. Examination under anesthesia confirmed the above findings, and no synchro-nous primaries are seen in the upper aerodigestive tract and esophagus. The biopsy is positive for invasive moderately well-differentiated squamous cell cancer, therefore staged as T2 N2a M0.