Tonsillar carcinoma

Case contributed by Saad Ahmed Saad Hassan
Diagnosis certain

Presentation

Right neck lump

Patient Data

Age: 70 years
Gender: Male

Neck

mri

A fairly well defined enhancing soft tissue mass is seen arising from the right tonsil, measuring 38 x 28 x 29 mm. The mass reaches the anterior and the posterior tonsillar pillars. The mass demonstrates a low signal on T1WI and a slightly high signal on T2WI's with mild homogeneous enhancement.

There is a right level II node that measures 42 mm in its greatest dimension, with cystic changes and heterogeneous enhancement.

Several other right cervical chain nodes (level III and level IV) are low volume but appear conspicuous compared to the left side, possibly indicating disease involvement. 

Case Discussion

Right tonsillar squamous cell carcinoma (T2N2b).

Pathology

Gross: Specimen: Right tonsil tumor. Macro: Piece of pale tissue 15 x 6 x 5 mm.

Histology: These are fragmented biopsies of right tonsillar tissue infiltrated by poorly differentiated squamous cell carcinoma. 

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