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Case Reports
. 2017 Aug;37(4):341-345.
doi: 10.14639/0392-100X-1281.

Papillary squamous cell carcinoma of the palatine tonsil: a rare cancer of the head and neck

A Serra  1 , R Caltabiano  2 , G Scalia  3 , S Palmucci  4 , P Di Mauro  1 , S Cocuzza  1
Affiliations
Case Reports

Papillary squamous cell carcinoma of the palatine tonsil: a rare cancer of the head and neck

A Serra et al. Acta Otorhinolaryngol Ital. 2017 Aug.

Abstract
in English, Italian

Papillary squamous neoplasms of the upper respiratory tract are rare variants of squamous cell carcinomas. They are characterised by an exophytic, papillary growth and generally have favourable prognosis. The tumour has been described in the upper aerodigestive tract. In this context, most common sites of involvement are the larynx and hypopharynx, and rarely the oral cavity and oropharynx. The limited studies and small number of published cases of papillary squamous cell carcinoma of the palatine tonsil led us to make a complete analysis of this tumour by analysing the clinical, histological, radiological, virological and therapeutic aspects that are not always present in the literature. A case of papillary squamous cell carcinoma of the palatine tonsil is reported. The lesion (T2N0M0) was located into the left palatine tonsil that hung towards the oral cavity. Both HPV 16 DNA and E6/E7 mRNA were detected in the lesion. The clinicopathological profile of the neoplasm is presented and a comprehensive review of recent literature was made by analysing all aspects of interest of this neoplasm.

Le neoplasie squamose papillari delle vie aeree digestive superiori sono una rara variante del carcinoma a cellule squamose. Sono caratterizzate da una crescita esofitica papillare e hanno una prognosi generalmente favorevole. Il tumore è già stato descritto a livello delle vie aeree digestive superiori. In tale contesto, le localizzazioni più frequenti sono la laringe e l’ipofaringe, mentre raramente sono interessati la cavità orale e l’ipofaringe. Gli studi limitati unitamente all’esiguo numero di casi pubblicati di carcinoma squamoso papillare a localizzazione tonsillare, ci hanno indotto a una completa analisi di questo tumore, analizzando gli aspetti clinici, istopatologici, radiologici, virologici e terapeutici, non sempre presenti in letteratura. Un case report di carcinoma squamoso papillare della tonsilla palatina è pertanto riportato. La lesione (T2N0M0), localizzata a livello della tonsilla palatina sinistra, si aggettava verso la cavità orale. HPV DNA 16 e mRNA E6/E7 erano rilevati nella lesione. Un profilo della neoplasia è pertanto presentato unitamente a una completa revisione della recente letteratura, analizzando tutti gli aspetti di interesse di tale neoplasia.

Keywords: Blot hybridization analysis; Human papillomavirus; Squamous neoplasm; Upper aerodigestive tract.

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Figures

Fig. 1.
Fig. 1.
Multidetector CT. Images A and B were acquired in different phases after contrast administration (arterial and venous phases respectively). A well-defined solid mass, oval in shape, is well depicted in the left tongue (white arrows).
Fig. 2.
Fig. 2.
Coronal reformatted MDCT image. Image clearly shows the lesion (white arrow), with moderate enhancement after contrast medium.
Fig. 3.
Fig. 3.
At gross examination an exuberant papillary neoplastic outgrowth in the tonsil was evident.
Fig. 4.
Fig. 4.
At low magnification, a characteristic papillary finger-like pattern of growth was evident (H&E x 25).
Fig. 5.
Fig. 5.
At high magnification, papillary stalks in PSCC showed well visible fibro-vascular axis and markedly pleomorphic immature-basaloid neoplastic cells (H&E x 200).
See this image and copyright information in PMC

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