Tonsillectomy in diagnosis of the unknown primary tumor of the head and neck

David A. Randall, Peter A S Johnstone, Robert D. Foss, Peter J. Martin

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: The purpose of this study was to discuss the experience of one tumor registry with performing tonsillectomy in the diagnostic approach to unknown head and neck primary tumors. It also describes the importance of including tonsillectomy in this evaluation algorithm. STUDY DESIGN: A retrospective chart review was done of 68 patients with either tonsillar or unknown primary squamous cell carcinoma culled from 829 patients seen from 1956 to 1996 at the head and neck tumor registry at the Naval Medical Center San Diego. METHODS: Records from the head and neck tumor registry, radiation oncology service, and pathology department were reviewed with attention to presenting symptom, initial examination, diagnostic studies performed, and type and result of biopsies performed. RESULTS: Thirty-four patients sought treatment for a neck lymph node metastasis of squamous cell carcinoma without an identifiable primary tumor site. Six of these (18%) had the primary site diagnosed by performing tonsillectomy ipsilateral to the presenting neck mass. Six of 14 T1 tonsillar carcinomas in this series had the primary site identified by tonsillectomy. CONCLUSIONS: Despite a diligent search, a primary tumor site may not be found in the head and neck cancer patient. The tonsil may harbor an occult squamous cell carcinoma. The patient benefits from identification of the initial tumor site because postoperative irradiation ports may be reduced and because surveillance for recurrence may be improved. For these reasons, tonsillectomy should be performed ipsilateral to the presenting cervical metastasis if no other primary tumor site is identified.

Original languageEnglish (US)
Pages (from-to)52-55
Number of pages4
JournalOtolaryngology - Head and Neck Surgery
Volume122
Issue number1
StatePublished - 2000
Externally publishedYes

Fingerprint

Unknown Primary Neoplasms
Tonsillectomy
Neck
Head
Neoplasms
Registries
Squamous Cell Carcinoma
Neoplasm Metastasis
Radiation Oncology
Palatine Tonsil
Head and Neck Neoplasms
Lymph Nodes
Pathology
Carcinoma
Biopsy
Recurrence

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Randall, D. A., Johnstone, P. A. S., Foss, R. D., & Martin, P. J. (2000). Tonsillectomy in diagnosis of the unknown primary tumor of the head and neck. Otolaryngology - Head and Neck Surgery, 122(1), 52-55.

Tonsillectomy in diagnosis of the unknown primary tumor of the head and neck. / Randall, David A.; Johnstone, Peter A S; Foss, Robert D.; Martin, Peter J.

In: Otolaryngology - Head and Neck Surgery, Vol. 122, No. 1, 2000, p. 52-55.

Research output: Contribution to journalArticle

Randall, DA, Johnstone, PAS, Foss, RD & Martin, PJ 2000, 'Tonsillectomy in diagnosis of the unknown primary tumor of the head and neck', Otolaryngology - Head and Neck Surgery, vol. 122, no. 1, pp. 52-55.
Randall, David A. ; Johnstone, Peter A S ; Foss, Robert D. ; Martin, Peter J. / Tonsillectomy in diagnosis of the unknown primary tumor of the head and neck. In: Otolaryngology - Head and Neck Surgery. 2000 ; Vol. 122, No. 1. pp. 52-55.
@article{928ae68d3ad747828f2ad350b075d03c,
title = "Tonsillectomy in diagnosis of the unknown primary tumor of the head and neck",
abstract = "OBJECTIVES: The purpose of this study was to discuss the experience of one tumor registry with performing tonsillectomy in the diagnostic approach to unknown head and neck primary tumors. It also describes the importance of including tonsillectomy in this evaluation algorithm. STUDY DESIGN: A retrospective chart review was done of 68 patients with either tonsillar or unknown primary squamous cell carcinoma culled from 829 patients seen from 1956 to 1996 at the head and neck tumor registry at the Naval Medical Center San Diego. METHODS: Records from the head and neck tumor registry, radiation oncology service, and pathology department were reviewed with attention to presenting symptom, initial examination, diagnostic studies performed, and type and result of biopsies performed. RESULTS: Thirty-four patients sought treatment for a neck lymph node metastasis of squamous cell carcinoma without an identifiable primary tumor site. Six of these (18{\%}) had the primary site diagnosed by performing tonsillectomy ipsilateral to the presenting neck mass. Six of 14 T1 tonsillar carcinomas in this series had the primary site identified by tonsillectomy. CONCLUSIONS: Despite a diligent search, a primary tumor site may not be found in the head and neck cancer patient. The tonsil may harbor an occult squamous cell carcinoma. The patient benefits from identification of the initial tumor site because postoperative irradiation ports may be reduced and because surveillance for recurrence may be improved. For these reasons, tonsillectomy should be performed ipsilateral to the presenting cervical metastasis if no other primary tumor site is identified.",
author = "Randall, {David A.} and Johnstone, {Peter A S} and Foss, {Robert D.} and Martin, {Peter J.}",
year = "2000",
language = "English (US)",
volume = "122",
pages = "52--55",
journal = "Otolaryngology - Head and Neck Surgery",
issn = "0194-5998",
publisher = "Mosby Inc.",
number = "1",

}

TY - JOUR

T1 - Tonsillectomy in diagnosis of the unknown primary tumor of the head and neck

AU - Randall, David A.

AU - Johnstone, Peter A S

AU - Foss, Robert D.

AU - Martin, Peter J.

PY - 2000

Y1 - 2000

N2 - OBJECTIVES: The purpose of this study was to discuss the experience of one tumor registry with performing tonsillectomy in the diagnostic approach to unknown head and neck primary tumors. It also describes the importance of including tonsillectomy in this evaluation algorithm. STUDY DESIGN: A retrospective chart review was done of 68 patients with either tonsillar or unknown primary squamous cell carcinoma culled from 829 patients seen from 1956 to 1996 at the head and neck tumor registry at the Naval Medical Center San Diego. METHODS: Records from the head and neck tumor registry, radiation oncology service, and pathology department were reviewed with attention to presenting symptom, initial examination, diagnostic studies performed, and type and result of biopsies performed. RESULTS: Thirty-four patients sought treatment for a neck lymph node metastasis of squamous cell carcinoma without an identifiable primary tumor site. Six of these (18%) had the primary site diagnosed by performing tonsillectomy ipsilateral to the presenting neck mass. Six of 14 T1 tonsillar carcinomas in this series had the primary site identified by tonsillectomy. CONCLUSIONS: Despite a diligent search, a primary tumor site may not be found in the head and neck cancer patient. The tonsil may harbor an occult squamous cell carcinoma. The patient benefits from identification of the initial tumor site because postoperative irradiation ports may be reduced and because surveillance for recurrence may be improved. For these reasons, tonsillectomy should be performed ipsilateral to the presenting cervical metastasis if no other primary tumor site is identified.

AB - OBJECTIVES: The purpose of this study was to discuss the experience of one tumor registry with performing tonsillectomy in the diagnostic approach to unknown head and neck primary tumors. It also describes the importance of including tonsillectomy in this evaluation algorithm. STUDY DESIGN: A retrospective chart review was done of 68 patients with either tonsillar or unknown primary squamous cell carcinoma culled from 829 patients seen from 1956 to 1996 at the head and neck tumor registry at the Naval Medical Center San Diego. METHODS: Records from the head and neck tumor registry, radiation oncology service, and pathology department were reviewed with attention to presenting symptom, initial examination, diagnostic studies performed, and type and result of biopsies performed. RESULTS: Thirty-four patients sought treatment for a neck lymph node metastasis of squamous cell carcinoma without an identifiable primary tumor site. Six of these (18%) had the primary site diagnosed by performing tonsillectomy ipsilateral to the presenting neck mass. Six of 14 T1 tonsillar carcinomas in this series had the primary site identified by tonsillectomy. CONCLUSIONS: Despite a diligent search, a primary tumor site may not be found in the head and neck cancer patient. The tonsil may harbor an occult squamous cell carcinoma. The patient benefits from identification of the initial tumor site because postoperative irradiation ports may be reduced and because surveillance for recurrence may be improved. For these reasons, tonsillectomy should be performed ipsilateral to the presenting cervical metastasis if no other primary tumor site is identified.

UR - http://www.scopus.com/inward/record.url?scp=0033957464&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033957464&partnerID=8YFLogxK

M3 - Article

C2 - 10629482

AN - SCOPUS:0033957464

VL - 122

SP - 52

EP - 55

JO - Otolaryngology - Head and Neck Surgery

JF - Otolaryngology - Head and Neck Surgery

SN - 0194-5998

IS - 1

ER -