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Jens Greve - One of the best experts on this subject based on the ideXlab platform.
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synchronous bilateral Tonsil carcinoma case presentation and review of the literature
Infectious Agents and Cancer, 2017Co-Authors: Marie-nicole Theodoraki, Johannes A. Veit, Thomas K. Hoffmann, Jens GreveAbstract: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. 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”. 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. 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.
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Synchronous bilateral Tonsil carcinoma: case presentation and review of the literature
BMC, 2017Co-Authors: Marie-nicole Theodoraki, Johannes A. Veit, Thomas K. Hoffmann, Jens GreveAbstract:Abstract 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
Joakim Dillner - One of the best experts on this subject based on the ideXlab platform.
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A novel human in vitro papillomavirus type 16 positive Tonsil Cancer cell line with high sensitivity to radiation and cisplatin
BMC Cancer, 2019Co-Authors: Ola Forslund, Natsuki Sugiyama, Chengjun Wu, Naveen Ravi, Sabine Swoboda, Fredrik Andersson, Davit Bzhalava, Emilie Hultin, Kajsa Paulsson, Joakim DillnerAbstract:Background Human papillomavirus (HPV) is an established risk factor for oropharyngeal squamous cell carcinoma (OSCC). The aim was to establish cell lines from HPV-positive Tonsil carcinomas to be used for treatment development. Methods Fresh samples from 23 HPV-positive Tonsil carcinomas were cultivated in vitro. The established cell line was analyzed for viral characteristics, cell karyotype, TP53 status, and growth capabilities in nude mice. In vitro studies of sensitivities to radiation, cisplatin and cetuximab were performed. Results After 19 months (eight passages), one cell line, LU-HNSCC-26, was established in vitro and also grew as xenografts. The tumor was from a 48 year old non-smoking man with non-keratinizing, p16 positive Tonsil OSCC, stage T2N0M0 with HPV16. It contained 19.5 (CV% 3.7) HPV16 copies/cell (passage 8). The complete HPV16 genome sequence was obtained. Episomal HPV16 was present with an E2/E7 ratio of 1.1 (CV% 2.6). In addition, HPV16 mRNA specific for the intact E2 gene was detected. The viral expression manifested 1.0 (CV% 0.1) E7 mRNA copies per HPV16 genome. The karyotype was determined and the cell line demonstrated wild type TP53 . The ID50 for radiation was 0.90 Gy and the IC50 for cisplatin was 0.99 μmol/L. The cell line was inhibited to a maximum of 18% by cetuximab. Conclusions We established an in vitro Tonsil carcinoma cell line containing episomal HPV16. This is an important step towards efficient treatment development.
Tejs Ehlers Klug - One of the best experts on this subject based on the ideXlab platform.
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prevalence of synchronous bilateral Tonsil squamous cell carcinoma a retrospective study
Clinical Otolaryngology, 2018Co-Authors: M S Rokkjaer, Tejs Ehlers KlugAbstract:Objectives The prevalence of synchronous bilateral Tonsil Cancer remains unexplored. To date, only 38 cases have been described in the literature. With an aim to substantiate the Danish recommendation of performing bilateral Tonsillectomy in patients with suspected or proven Tonsil Cancer and in patients with cervical carcinoma metastasis from an unknown primary tumour, this study was undertaken to determine the prevalence of synchronous bilateral Tonsil Cancer. Design A retrospective review of all patients diagnosed with Tonsil Cancer in the period 2000-2015, Aarhus University Hospital, Denmark, was performed. Results Seven of 211 (3.3%) consecutive patients with Tonsil Cancer, who had undergone bilateral Tonsillectomy (n = 180) or unilateral Tonsillectomy (clinically normal side) combined with contralateral Tonsil biopsy (side with suspected Cancer) (n = 31), had synchronous bilateral Tonsil Cancer. Furthermore, dysplasia was found in the contralateral Tonsil in two patients with unilateral Tonsil Cancer. Four of 171 (2.3%) patients with suspected unilateral Tonsillar Cancer had additional contralateral Tonsil Cancer. Three of 34 (8.8%) patients without clinical signs of Tonsillar malignancy on any side (32 patients with carcinoma of unknown primary) had synchronous bilateral Tonsil Cancer. In none of the patients were bilateral Tonsil Cancer suspected. Patients with unilateral vs synchronous bilateral Tonsil Cancer had similar clinical and tumour characteristics. Conclusion Knowledge on additional contralateral synchronous Tonsil Cancer is crucial for avoidance of early recurrence of oropharyngeal Cancer in patients with Tonsil Cancer. Based on our findings, we recommend bilateral Tonsillectomy in all patients with suspected or proven Tonsil Cancer and carcinoma of unknown primary.
Adam Raben - One of the best experts on this subject based on the ideXlab platform.
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freedom from local and regional failure of contralateral neck with ipsilateral neck radiotherapy for node positive Tonsil Cancer updated results of an institutional clinical management approach
Oral Oncology, 2015Co-Authors: Tu Dan, David Raben, Charles Schneider, Neil G Hockstein, Robert L Witt, Michael Dzeda, Jennifer F Cormier, Adam RabenAbstract:Summary Purpose To update the outcomes of an institutional clinical management approach using ipsilateral neck radiotherapy in the treatment of node-positive squamous cell carcinoma of the Tonsil with a well-lateralized primary lesion. Methods and Materials Between August 2003 and April 2014, 61 consecutive patients with ipsilateral node-positive squamous cell carcinoma of the Tonsil without involvement of the base of the tongue or midline soft palate were treated at a community hospital-based Cancer center with radiotherapy to the primary site and ipsilateral neck. Overall survival, disease-free survival and freedom from contralateral failure were calculated. Results Median follow up was 37.2 months (range 4–121 months). Freedom from contralateral nodal failure at 5 years was 98% with one contralateral nodal failure noted. The patient underwent a salvage neck dissection and was treated with post-operative radiotherapy with no evidence of disease to date. 5-year overall survival (OS) was 92.4% and 5 year disease-free survival (DFS) was 86.7%. Conclusions This represents the single largest series reported from a community hospital-based Cancer center in which lateralized Tonsil Cancers with N+ disease were treated with ipsilateral neck radiotherapy. In this carefully selected cohort of patients with well-lateralized Tonsil Cancers, the risk of contralateral nodal failure appears to be
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freedom from local and regional failure of contralateral neck with ipsilateral neck radiotherapy for node positive Tonsil Cancer results of a prospective management approach
International Journal of Radiation Oncology Biology Physics, 2009Co-Authors: Kyle E Rusthoven, David Raben, Robert L Witt, Charles J Schneider, Sarah Sammons, Adam RabenAbstract:Purpose To review the outcomes of a prospective management approach using ipsilateral neck radiotherapy in the treatment of node-positive squamous cell carcinoma of the Tonsil with a well-lateralized primary lesion. Methods and Materials Between August 2003 and June 2007, 20 patients who presented with squamous cell carcinoma of the Tonsil, without involvement of the base of the tongue or midline soft palate, and with Stage N1-N2b disease were prospectively treated with radiotherapy to the primary site and ipsilateral neck. In addition, 18 patients received concurrent chemotherapy. The actuarial freedom from contralateral nodal and in-field progression was determined. Acute and late toxicity were prospectively evaluated using the National Cancer Institute Common Terminology Criteria for Adverse Events, version 3, and Radiation Therapy Oncology Group criteria. Results The nodal disease was Stage N1 in 4 patients, N2a in 3 patients, and N2b in 13 patients. At a median follow-up 19 months (range, 12–40), no in-field or contralateral nodal recurrences had been observed. The 2-year freedom from distant metastasis rate was 87.4%. The actuarial 2-year disease-free and overall survival rates were both 79.5%. Late Radiation Therapy Oncology Group grade 2 xerostomia occurred in 1 patient (5%). No late Grade 3 or greater toxicity was observed. No patient was feeding tube dependent at their last follow-up visit. Conclusion In carefully selected patients with node-positive, lateralized Tonsillar Cancer, treatment of the ipsilateral neck and primary site does not appear to increase the risk of contralateral nodal failure and reduces late morbidity compared with historical controls. Although the outcomes with ipsilateral radiotherapy in the present series were promising, these findings require longer follow-up and validation in a larger patient cohort.
Young Soo Rho - One of the best experts on this subject based on the ideXlab platform.
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pattern of cervical lymph node metastasis in Tonsil Cancer predictive factor analysis of contralateral and retropharyngeal lymph node metastasis
Oral Oncology, 2011Co-Authors: Eunjae Chung, Kyu Young Choi, Dong Jin Lee, Il Seok Park, Jin Hwan Kim, Young Soo RhoAbstract:The purpose of this study was to determine the pattern of cervical lymph node metastasis in Tonsil Cancer including the retropharyngeal (RPLN) nodal metastasis. Seventy-six Tonsillar squamous cell carcinoma patients who underwent surgery-based treatment were retrospectively analyzed. Most patients had advanced stage (stages III and IV: 81.6%) Tonsil Cancer. Sixteen patients were treated with surgery only. Postoperative radiotherapy was performed to 38 patients, and chemoradiation to 22 patients. Seventy-one therapeutic neck dissections and 27 elective neck dissections were performed. Thirty-four patients underwent RPLN dissection based on the preoperative inclusion criteria. There was a statistically significant metastasis in level I or V nodes, when the ipsilateral multilevel, or contralateral nodes were positive. The rate of contralateral occult cases was 28.6%. T3-4 stages, primary lesions close to the midline, or ipsilateral multilevel involvement were significantly associated with contralateral metastasis. Ipsilateral multilevel involvement was the independent factor with multivariate analysis. RPLN metastasis was confirmed in 9 of the 34 (26.5%) subjects. Disease-specific survival rate was significantly different according to RPLN status (82.1% vs. 55.6%; p=0.021). Positive pre-operative image, posterior pharyngeal wall invasion, more than N2 stage, contralateral node metastasis, or ipsilateral multilevel involvement were correlated with RPLN metastasis. Bilateral neck dissection is mandatory for primary lesions close to the midline and advanced ipsilateral nodal disease. Elective RPLN dissection should be considered for patients with advanced neck and primary tumor, particularly for tumors with posterior pharyngeal wall invasion.