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Head and Neck
Diagnosis
Primary Sites, Perineural Tumor and Nodes
Oropharyngeal Carcinoma
Palatine Tonsil Squamous Cell Carcinoma
Palatine Tonsil Squamous Cell Carcinoma
Bronwyn E. Hamilton, MD; Luke N. Ledbetter, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Palatine tonsil squamous cell carcinoma (SCCa)

            • Synonyms

              • Faucial tonsil SCCa

            • Definitions

              • Epithelial malignant neoplasm arising in lateral oropharynx involving tonsillar fossa or pillars
                • May be referred to as tonsillar complex
              • Oropharyngeal subsites: Palatine tonsil, base of tongue, posterior pharyngeal wall, soft palate

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Nuclear Medicine Findings

                    • Ultrasonographic Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Image Interpretation Pearls

                                            • Reporting Tips

                                              Selected References

                                              1. Jamal Z et al: Oropharyngeal squamous cell carcinoma. StatPearls, 2021
                                              2. Tham T et al: Anatomical subsite modifies survival in oropharyngeal squamous cell carcinoma: National Cancer Database study. 42(3):434-45, 2020
                                              3. Lee B et al: Prognostic value of radiologic extranodal extension in human papillomavirus-related oropharyngeal squamous cell carcinoma. Head and Neck. Korean J Radiol. 20(8):1266-74, 2019
                                              4. Lin TA et al: Radiographic retropharyngeal lymph node involvement in HPV-associated oropharyngeal carcinoma: patterns of involvement and impact on patient outcomes. Cancer. 125(9):1536-46, 2019
                                              5. Moan JM et al: The prognostic role of 18F-fluorodeoxyglucose PET in head and neck cancer depends on HPV status. Radiother Oncol. 140:54-61, 2019
                                              6. Rassy E et al: Comprehensive management of HPV-related squamous cell carcinoma of the head and neck of unknown primary. Head Neck. 41(10):3700-11, 2019
                                              7. Rulach R et al: 12 week PET-CT has low positive predictive value for nodal residual disease in human papillomavirus-positive oropharyngeal cancers. Oral Oncol. 97:76-81, 2019
                                              8. Choi YJ et al: Histogram analysis of apparent diffusion coefficients for occult tonsil cancer in patients with cervical nodal metastasis from an unknown primary site at presentation. Radiology. 278(1):146-55, 2016
                                              9. Chi AC et al: Oral cavity and oropharyngeal squamous cell carcinoma--an update. CA Cancer J Clin. 65(5):401-21, 2015
                                              10. Sood AJ et al: The association between T-stage and clinical nodal metastasis In HPV-positive oropharyngeal cancer. Am J Otolaryngol. 35(4):463-8, 2014
                                              11. Corey A: Pitfalls in the staging of cancer of the oropharyngeal squamous cell carcinoma. Neuroimaging Clin N Am. 23(1):47-66, 2013
                                              12. Loevner LA et al: Transoral robotic surgery in head and neck cancer: what radiologists need to know about the cutting edge. Radiographics. 33(6):1759-79, 2013
                                              13. Trotta BM et al: Oral cavity and oropharyngeal squamous cell cancer: key imaging findings for staging and treatment planning. Radiographics. 31(2):339-54, 2011
                                              14. Davison JM et al: Squamous cell carcinoma of the palatine tonsils: FDG standardized uptake value ratio as a biomarker to differentiate tonsillar carcinoma from physiologic uptake. Radiology. 255(2):578-85, 2010
                                              15. Hannisdal K et al: Human papillomavirus (HPV)-positive tonsillar carcinomas are frequent and have a favourable prognosis in males in Norway. Acta Otolaryngol. 130(2):293-9, 2010
                                              16. Marur S et al: HPV-associated head and neck cancer: a virus-related cancer epidemic. Lancet Oncol. 11(8):781-9, 2010
                                              17. Tshering Vogel DW et al: Cancer of the oral cavity and oropharynx. Cancer Imaging. 10:62-72, 2010
                                              18. Ernster JA et al: Prevalence of oncogenic human papillomavirus 16 and 18 in the palatine tonsils of the general adult population. Arch Otolaryngol Head Neck Surg. 135(6):554-7, 2009
                                              19. Luginbuhl A et al: Prevalence, morphology, and prognosis of human papillomavirus in tonsillar cancer. Ann Otol Rhinol Laryngol. 118(10):742-9, 2009
                                              20. Cobo F et al: Review article: relationship of human papillomavirus with papillary squamous cell carcinoma of the upper aerodigestive tract: a review. Int J Surg Pathol. 16(2):127-36, 2008
                                              21. Stambuk HE et al: Oral cavity and oropharynx tumors. Radiol Clin North Am. 45(1):1-20, 2007
                                              22. Zima AJ et al: Magnetic resonance imaging of oropharyngeal cancer. Top Magn Reson Imaging. 18(4):237-42, 2007
                                              23. Jumper JR et al: The "small, dark tonsil" in patients presenting with metastatic cervical lymphadenopathy from an unknown primary. AJNR Am J Neuroradiol. 26(2):411-3, 2005
                                              24. Cinar F: Significance of asymptomatic tonsil asymmetry. Otolaryngol Head Neck Surg. 131(1):101-3, 2004
                                              25. Venuti A et al: Presence of HPV in head and neck tumours: high prevalence in tonsillar localization. J Exp Clin Cancer Res. 23(4):561-6, 2004
                                              26. Kawabe J et al: Physiological FDG uptake in the palatine tonsils. Ann Nucl Med. 15(3):297-300, 2001
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Pathology

                                                      • Clinical Issues

                                                        TERMINOLOGY

                                                        • Abbreviations

                                                          • Palatine tonsil squamous cell carcinoma (SCCa)

                                                        • Synonyms

                                                          • Faucial tonsil SCCa

                                                        • Definitions

                                                          • Epithelial malignant neoplasm arising in lateral oropharynx involving tonsillar fossa or pillars
                                                            • May be referred to as tonsillar complex
                                                          • Oropharyngeal subsites: Palatine tonsil, base of tongue, posterior pharyngeal wall, soft palate

                                                        IMAGING

                                                        • General Features

                                                          • CT Findings

                                                            • MR Findings

                                                              • Nuclear Medicine Findings

                                                                • Ultrasonographic Findings

                                                                  • Imaging Recommendations

                                                                    DIFFERENTIAL DIAGNOSIS

                                                                      PATHOLOGY

                                                                      • General Features

                                                                        • Staging, Grading, & Classification

                                                                          • Gross Pathologic & Surgical Features

                                                                            • Microscopic Features

                                                                              CLINICAL ISSUES

                                                                              • Presentation

                                                                                • Demographics

                                                                                  • Natural History & Prognosis

                                                                                    • Treatment

                                                                                      DIAGNOSTIC CHECKLIST

                                                                                      • Image Interpretation Pearls

                                                                                        • Reporting Tips

                                                                                          Selected References

                                                                                          1. Jamal Z et al: Oropharyngeal squamous cell carcinoma. StatPearls, 2021
                                                                                          2. Tham T et al: Anatomical subsite modifies survival in oropharyngeal squamous cell carcinoma: National Cancer Database study. 42(3):434-45, 2020
                                                                                          3. Lee B et al: Prognostic value of radiologic extranodal extension in human papillomavirus-related oropharyngeal squamous cell carcinoma. Head and Neck. Korean J Radiol. 20(8):1266-74, 2019
                                                                                          4. Lin TA et al: Radiographic retropharyngeal lymph node involvement in HPV-associated oropharyngeal carcinoma: patterns of involvement and impact on patient outcomes. Cancer. 125(9):1536-46, 2019
                                                                                          5. Moan JM et al: The prognostic role of 18F-fluorodeoxyglucose PET in head and neck cancer depends on HPV status. Radiother Oncol. 140:54-61, 2019
                                                                                          6. Rassy E et al: Comprehensive management of HPV-related squamous cell carcinoma of the head and neck of unknown primary. Head Neck. 41(10):3700-11, 2019
                                                                                          7. Rulach R et al: 12 week PET-CT has low positive predictive value for nodal residual disease in human papillomavirus-positive oropharyngeal cancers. Oral Oncol. 97:76-81, 2019
                                                                                          8. Choi YJ et al: Histogram analysis of apparent diffusion coefficients for occult tonsil cancer in patients with cervical nodal metastasis from an unknown primary site at presentation. Radiology. 278(1):146-55, 2016
                                                                                          9. Chi AC et al: Oral cavity and oropharyngeal squamous cell carcinoma--an update. CA Cancer J Clin. 65(5):401-21, 2015
                                                                                          10. Sood AJ et al: The association between T-stage and clinical nodal metastasis In HPV-positive oropharyngeal cancer. Am J Otolaryngol. 35(4):463-8, 2014
                                                                                          11. Corey A: Pitfalls in the staging of cancer of the oropharyngeal squamous cell carcinoma. Neuroimaging Clin N Am. 23(1):47-66, 2013
                                                                                          12. Loevner LA et al: Transoral robotic surgery in head and neck cancer: what radiologists need to know about the cutting edge. Radiographics. 33(6):1759-79, 2013
                                                                                          13. Trotta BM et al: Oral cavity and oropharyngeal squamous cell cancer: key imaging findings for staging and treatment planning. Radiographics. 31(2):339-54, 2011
                                                                                          14. Davison JM et al: Squamous cell carcinoma of the palatine tonsils: FDG standardized uptake value ratio as a biomarker to differentiate tonsillar carcinoma from physiologic uptake. Radiology. 255(2):578-85, 2010
                                                                                          15. Hannisdal K et al: Human papillomavirus (HPV)-positive tonsillar carcinomas are frequent and have a favourable prognosis in males in Norway. Acta Otolaryngol. 130(2):293-9, 2010
                                                                                          16. Marur S et al: HPV-associated head and neck cancer: a virus-related cancer epidemic. Lancet Oncol. 11(8):781-9, 2010
                                                                                          17. Tshering Vogel DW et al: Cancer of the oral cavity and oropharynx. Cancer Imaging. 10:62-72, 2010
                                                                                          18. Ernster JA et al: Prevalence of oncogenic human papillomavirus 16 and 18 in the palatine tonsils of the general adult population. Arch Otolaryngol Head Neck Surg. 135(6):554-7, 2009
                                                                                          19. Luginbuhl A et al: Prevalence, morphology, and prognosis of human papillomavirus in tonsillar cancer. Ann Otol Rhinol Laryngol. 118(10):742-9, 2009
                                                                                          20. Cobo F et al: Review article: relationship of human papillomavirus with papillary squamous cell carcinoma of the upper aerodigestive tract: a review. Int J Surg Pathol. 16(2):127-36, 2008
                                                                                          21. Stambuk HE et al: Oral cavity and oropharynx tumors. Radiol Clin North Am. 45(1):1-20, 2007
                                                                                          22. Zima AJ et al: Magnetic resonance imaging of oropharyngeal cancer. Top Magn Reson Imaging. 18(4):237-42, 2007
                                                                                          23. Jumper JR et al: The "small, dark tonsil" in patients presenting with metastatic cervical lymphadenopathy from an unknown primary. AJNR Am J Neuroradiol. 26(2):411-3, 2005
                                                                                          24. Cinar F: Significance of asymptomatic tonsil asymmetry. Otolaryngol Head Neck Surg. 131(1):101-3, 2004
                                                                                          25. Venuti A et al: Presence of HPV in head and neck tumours: high prevalence in tonsillar localization. J Exp Clin Cancer Res. 23(4):561-6, 2004
                                                                                          26. Kawabe J et al: Physiological FDG uptake in the palatine tonsils. Ann Nucl Med. 15(3):297-300, 2001