Bilateral Synchronous Tonsillar Carcinoma

Bilateral Synchronous Tonsillar Carcinoma

Introduction: The tonsils are the most common site of occult primaries in the oropharynx with a reported incidence of 18%-44%. Bilateral synchronous tonsillar carcinoma has been reported 15 times in the literature however the incidence is likely to be much higher as bilateral tonsillectomy in the work-up of a patient with cervical metastases of unknown primary origin is not routine practice in all centres.

Methods: A case series of four patients presenting with metastatic squamous cell carcinoma (SCC) in cervical lymph nodes with unknown primaries found on bilateral tonsillectomy to have bilateral synchronous tonsillar carcinoma.

Discussion: This cases series supports the case for bilateral tonsillectomy to become standard practice in the work-up of a patient with cervical metastases of unknown primary origin.