Volume 03 Issue 07-2023
1
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
07
P
AGES
:
01-04
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
ABSTRACT
Tonsillar metastasis from sarcomatoid carcinoma of the lung is an exceedingly rare occurrence. We present a case of
a 62-year-old male with a known history of sarcomatoid carcinoma of the lung who presented with progressive
dysphagia and a mass in the left tonsil. The patient underwent biopsy of the tonsillar mass, which revealed metastatic
sarcomatoid carcinoma. To the best of our knowledge, this is one of the few reported cases of tonsillar metastasis
from sarcomatoid carcinoma of the lung. This case highlights the importance of considering distant metastasis in
patients with a history of sarcomatoid carcinoma of the lung who present with atypical symptoms.
KEYWORDS
Tonsillar metastasis, sarcomatoid carcinoma, lung cancer, rare presentation, dysphagia, distant metastasis.
INTRODUCTION
Tonsillar metastasis from sarcomatoid carcinoma of
the lung is an extremely rare occurrence. Sarcomatoid
carcinoma, also known as pleomorphic carcinoma, is a
highly aggressive subtype of lung cancer characterized
by both epithelial and mesenchymal components.
While lung cancer commonly metastasizes to regional
Research Article
TONSILLAR METASTASIS FROM SARCOMATOID CARCINOMA LUNG: A
RARE PRESENTATION
Submission Date:
June 21, 2023,
Accepted Date:
June 26, 2023,
Published Date:
July 01, 2023
Crossref doi:
https://doi.org/10.37547/ijmscr/Volume03Issue07-01
Neelima Nair
Assistant Professor, Department of Pathology, Regional Cancer Centre, Trivandrum, India
Journal
Website:
https://theusajournals.
com/index.php/ijmscr
Copyright:
Original
content from this work
may be used under the
terms of the creative
commons
attributes
4.0 licence.
Volume 03 Issue 07-2023
2
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
07
P
AGES
:
01-04
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
lymph nodes, distant metastases to the tonsils are
exceptionally uncommon. Due to the rarity of this
presentation, there is limited literature available
regarding its clinical features, diagnosis, and
management. In this report, we present a case of
tonsillar metastasis from sarcomatoid carcinoma of the
lung and discuss its clinical implications.
Tonsillar metastasis from sarcomatoid carcinoma of
the lung is an uncommon occurrence that presents
diagnostic challenges due to its rarity and similarity to
primary tonsillar malignancies. Sarcomatoid carcinoma
is a highly aggressive subtype of lung cancer
characterized by a biphasic histological pattern
comprising
both
epithelial
and
sarcomatoid
components.
While
lung
cancer
commonly
metastasizes to regional lymph nodes and distant
organs, involvement of the tonsils is an unusual
manifestation. Recognizing and accurately diagnosing
tonsillar metastasis in the setting of sarcomatoid
carcinoma of the lung is crucial for appropriate
management and treatment planning.
The tonsils are part of the Waldeyer's ring, a lymphoid
tissue ring located in the oropharynx, and are known
to be a site of primary malignancies such as tonsillar
squamous cell carcinoma. However, secondary
involvement of the tonsils by metastatic tumors,
especially from extrapharyngeal primary sources like
lung cancer, is relatively rare. Tonsillar metastasis is
often associated with advanced disease and carries a
poor prognosis. Therefore, understanding the clinical
presentation, diagnostic approach, and management
strategies for this unique presentation is essential for
providing optimal care to patients.
In this case report, we describe a rare presentation of
tonsillar metastasis from sarcomatoid carcinoma of the
lung and discuss the diagnostic challenges, treatment
options, and prognosis associated with this condition.
Through an exploration of the clinical features,
imaging findings, histopathological analysis, and
therapeutic interventions, we aim to contribute to the
existing knowledge regarding this infrequent
manifestation. Improved awareness and early
recognition of tonsillar metastasis in patients with
sarcomatoid carcinoma of the lung can facilitate timely
and appropriate management, potentially impacting
patient outcomes.
By presenting this case and discussing the diagnostic
and therapeutic considerations, we hope to enhance
the understanding of this rare presentation among
healthcare professionals and highlight the importance
of a multidisciplinary approach in the management of
such cases.
METHOD
A detailed case study was conducted to describe the
clinical presentation, diagnostic evaluation, and
management approach for tonsillar metastasis from
sarcomatoid carcinoma of the lung. The medical
Volume 03 Issue 07-2023
3
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
07
P
AGES
:
01-04
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
records, imaging findings, pathology reports, and
treatment modalities of the patient were thoroughly
reviewed and analyzed. Relevant literature was also
reviewed to provide a comprehensive understanding
of this rare presentation. The study adhered to ethical
guidelines and maintained patient confidentiality.
Through this case study, we aim to contribute to the
existing div of knowledge on tonsillar metastasis
from sarcomatoid carcinoma of the lung, shedding
light on its clinical characteristics, diagnostic
challenges, and treatment considerations. The findings
of this study may help improve early detection and
appropriate management strategies for similar cases in
the future.
RESULTS
In our case study, we presented a 62-year-old male with
a known history of sarcomatoid carcinoma of the lung
who presented with progressive dysphagia and a mass
in the left tonsil. The patient underwent a biopsy of the
tonsillar mass, which revealed metastatic sarcomatoid
carcinoma. Imaging studies, including CT scans and
PET-CT, confirmed the presence of lung cancer with
tonsillar metastasis. The patient was evaluated by a
multidisciplinary team and underwent palliative
chemotherapy and supportive care.
DISCUSSION
Tonsillar metastasis from sarcomatoid carcinoma of
the lung is an extremely rare phenomenon, with only a
few reported cases in the literature. This presentation
poses diagnostic challenges as it may mimic primary
tonsillar malignancies or other benign conditions. The
clinical manifestations, such as dysphagia, throat pain,
or mass in the tonsil, can be nonspecific and easily
overlooked. Imaging studies, including CT scans and
PET-CT, play a crucial role in confirming the diagnosis
and assessing the extent of the disease.
The management of tonsillar metastasis from
sarcomatoid carcinoma of the lung is complex and
requires a multidisciplinary approach. Treatment
options may include palliative chemotherapy, radiation
therapy, targeted therapies, and supportive care
measures. However, the prognosis for patients with
sarcomatoid carcinoma of the lung is generally poor
due to its aggressive nature and propensity for
metastasis.
CONCLUSION
Tonsillar metastasis from sarcomatoid carcinoma of
the lung is an extremely rare presentation that requires
a high index of suspicion for accurate diagnosis.
Clinicians should consider distant metastasis in
patients with a known history of sarcomatoid
carcinoma of the lung who present with atypical
symptoms involving the tonsils. Imaging studies, such
as CT scans and PET-CT, are essential in confirming the
Volume 03 Issue 07-2023
4
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
07
P
AGES
:
01-04
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
diagnosis and guiding treatment decisions. A
multidisciplinary approach is crucial for the
management of these cases, with palliative
chemotherapy and supportive care being the mainstay
of treatment. Further research and case studies are
needed to enhance our understanding of this rare
presentation and improve patient outcomes.
REFERENCES
1.
Hyams VJ. Differential diagnosis of neoplasia of the
palatine tonsil. Clin Otolaryngol Allied Sci 1978; 3:
117-126.
2.
Unsal M, Kutlar G, Sullu Y and Yurtlu S: Tonsillar
metastasis of small cell lung carcinoma. ClinRespir
J 2016 ;10: 681-683.
3.
Arroyo HH, Takehara J, Ogawa AI, Frizzarini R,
Imamura R, Paula HM. Small cell lung carcinoma
metastasis
to
palatine
tonsils.
Braz
J
Otorhinolaryngol. 2013; 79:645.
4.
Yaren A, Degirmencioglu S, Topsakal S, Yuksel S, Bir
F, et al. Tonsillar metastasis from small cell lung
cancer: rare but occurs. Turkish J Cancer 2009;39:
28-30.
5.
Mastronikolis NS, Tsiropoulos GE, Chorianopoulos
D, Liava AC, Stathas T, et al. Palatine tonsillar
metastasis from lung adenocarcinoma. Eur Rev
Med Pharmacol Sci2007;11: 279-282.
6.
Wu Y, Zhu Z, Chen Y, et al. Tonsillar metastasis of
non-small cell lung cancer with G719S mutation in
exon 18: a case report. Medicine (Baltimore) 2017;
96: e9003.
7.
Tajima S and Koda K: Palatine tonsillar metastasis
of a small pulmonary adenocarcinoma showing an
invasive micropapillary carcinoma pattern and
Pagetoid spread at the tonsil: A case suggesting
retrograde lymphatic metastasis from bulky lymph
node metastases of the neck. Int J Clin Exp Pathol
8: 13601-13653, 2015.
8.
Tian Y, Han Y, Du J, Zhang Y, Liu N, Du X, et al.
Palatine
tonsillar
metastasis
of
lung
adenocarcinoma:
an
unusual
immunohistochemical phenotype and a potential
diagnostic pitfall. Int J Clin Exp Pathol.
2019;12(6):2288-92.
9.
Zaubitzer L, Rotter N, Aderhold C, Gaiser T,
Jungbauer F, Kramer B, et al. Metastasis of
pulmonary adenocarcinoma to the palatine tonsil.
Molecular and clinical oncology. 2019 Feb
1;10(2):231-4.
10.
Brownson RJ, Jaques WE, Lamonte SE, Zollinger
WK. Hypernephroma metastatic to the palatine
tonsils. Ann Otol Rhinol Laryngol.1979; 88: 235
–
40.
