Cancer of the tonsil presenting as central nervous system metastasis: A case report
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Abstract:
Metastases from tonsilar cancers are uncommon, usually found in the lung and less commonly in the bone, liver, and mediastinal sites. Only approximately 20% of patients die from distant metastasis. Central nervous system (CNS) metastases usually appear later in the course of the disease, with only 1% to 2% of patients developing metastasis involving the CNS in the course of their disease. Patients seen with symptomatic CNS lesions are rare.A case report is presented of a patient seen with signs and symptoms of CNS disease from an isolated CNS metastasis. The primary site was ultimately determined to be of tonsilar origin. The patient's treatment and outcome are discussed.Tonsilar cancers seen with signs and symptoms of CNS disease is a rare event. The benefit of aggressive treatment of isolated CNS metastasis from head and neck cancers will likely be gained from case reports because the incidence is quite low.Keywords:
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The incidence of tonsil cancers has increased in several countries. French data on HPV prevalence in tonsil cancers are scarce. The objective of this study was thus to assess the overall and type specific HPV prevalence in tonsil histological samples.This French retrospective multicenter study involved 12 centres located throughout the country. Were included 185 histological samples collected from year 2000 to 2009 with a validated diagnosis of tonsil invasive carcinomas. HPV prevalence was studied according to gender, age and histological type of cancer.Overall HPV prevalence was 57% in tonsil cancers. Mean age of diagnosis was comparable in HPV positive tonsils cases (60 ± 11.2) and HPV negative tonsil cases (59 ± 9.6). HPV prevalence was significantly higher in female than in male cases (28/35 versus 78/150 in tonsil cases, respectively, P = 0.003). About 53% of tonsil cases were infected by a single HPV type. Only eight (4%) samples were infected by more than one HPV type. Among HPV positive samples, HPV 16 was found in 89% of tonsil cases. All other HPV types had prevalence below 5%.Our results indicate that HPV is common in tonsil carcinomas and emphasize the predominant role of HPV 16.
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It is important to make the immunological role of the tonsil clear, comparing the responses of tonsil with those of the spleen and lymphnodes which are known as peripheral lymphatic organs.These experiments were condutcd to learn whether the antigenic information in the tonsil induced the antibody formation of anothe lymphatic organs. The experimental procedures are as follows:1) Adult rabbits were sensitized intravenously and peritonsillarlly with SRBC in vivo, and tonsil, spleeen and lymphnode cells were cultured in vitro. Simultaneously, non-sensitized spleen cells were cultured with sensitized tonsil cells, with sensitized spleen cells and with sensitized lymphnode cells.2) 4 days after, the antibody forming cells (plaque forming cells) were meassured by Jerne's hemolytic plaque technique.The following conclusions were drawn from this study:1) Live cells of 42% were harvested after 4-day culture.2) PFC number per 106 wore away to 1/2-1/10, in both single culture and mixed culture.3) On the whole, mixed culture was inclined to increase its number of PFC.4) In the group of one-time i. v. sensitization, only IgM-PFC of tonsil increased in number in mixed culture.5) In the group of repeated i. v. sensitization, every organ had the tendency of increase in number of PFC.6) In the group of peritonsillar sensitization, a small number of PFC was recognized in tonsil.Especially none of IgM-PFC was found in single culture, but mixed culture resulted is appearance of PFC.Discussions were done on the mechanism of the increase in number of PFC in mixed culture, and the ability of transfer of antigenic information of the tonsil.
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Objective To explore treatment of the microwaye therapy in tonsil. Method We have been analysed a total of 120 about enlargement of tonsil, chronic tonsil, which adopted CYⅢmicrowave heating solidification. Results A total of 120 treatment was very high effect, postsurgical pain was lower, albuginy was early,wound healing was faster. Conclusion The treatment of microwave therapy was effection in tonsils, the method would be elimination.
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THE purpose of this report is to present the findings of a review of 32 consecutive patients with carcinoma of the tonsil admitted to the University of Oklahoma Medical Center during a ten-year period from 1957-1966. This review includes the age and sex distribution, initial symptoms, clinical staging, pathologic findings, treatment, and survival statistics.
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Tumors of the tonsil by definition are those arising in the tonsil or tonsillar fossa including the tonsillar pillars.1Although it is felt that these lesions represent separate entities, it is usually difficult to classify them clinically as to specific site of origin, and they are therefore studied together.2This lesion accounts for 1.5% to 3% of all cancers3-5and is second in frequency only to carcinoma of the larynx among malignancies of the upper respiratory tract.3,6 Cancer of the tonsil is predominantly a disease of males asTonsil
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Tissue transfer concentration of cefminox (CMNX) in the tonsil was measured in 10 adults and 8 children after tonsillectomy. One gram of CMNX was injected intravenously before tonsillectomy, and its concentrations in the tonsil and in the serum were measured after tonsil had been removed.1. In adults, mean CMNX concentration in the tonsil was 15.8μg/mg 40 to 120 minutes after administration. Tonsillar concentration was 33.1% of serum concentration.2. In children, mean CMNX concentration in the tonsil was 20.9μg/mg 25 to 100 minutes after sdministration. Tonsillar concentration was 17.4% of serum concentration.3. The half-life of CMNX in the serum was 115 minutes in adults and 83 minutes in children.CMNX is effective against a variety of bacteria. The present study proved that the administration of one gram of CMNX was sufficient to treat tonsillitis and peritonsillar abscess, since its concentration in the tonsil was above the MIC80 of most bacterial.
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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.A retrospective review of all patients diagnosed with tonsil cancer in the period 2000-2015, Aarhus University Hospital, Denmark, was performed.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.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.
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The ability of human tonsil lymphocytes to give an anti-SRBC response in conventional cultures and in microcultures was studied. It was found that about two-thirds of tonsils responded with a significant number of plaque-forming cells (PFC), and that in some instances the response could be augmented if allogeneic tonsil cell (irradiated or intact) were added. Moreover, tonsil lymphocytes which failed to give a response on their own often responded upon addition of an appropriate number of allogeneic tonsil cells. The response was remarkably improved if allogeneic tonsil supernatant or conditioned medium were added. An anti-SRBC response was also obtained if SRBC was omitted from the cultures. The frequency of anti-SRBC specific B cells was estimated as 1/60000 (f = 1-7 X 10(-5)).
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The bioavailability of ofloxacin in tonsil tissue, after a single oral dose of 200 mg 2 h before surgery, was evaluated in 14 patients undergoing tonsillectomy for recurrent or chronic infection. A blood specimen was obtained just before drug administration and at the time of tonsillectomy, together with a specimen of tonsil tissue. The mean values of the serum and tonsil concentrations 2h after a single dose of 200 mg were 1·17 mg/1 ± 0·47 and 1–61 mg/1 ± 0·62 respectively with a mean tonsil/serum ratio of 1 ·40± 0·19. These values indicate good penetration of ofloxacin into tonsil tissue. No clinical or biological side-effects were observed.
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