Abstract
Objectives:
The most recent review of bilateral synchronous tonsillar carcinoma published in 2012 identified 12 previously described cases in the literature. It has been estimated that there is a 10% incidence of contralateral nodal metastasis from tonsillar carcinoma. However, the true incidence of bilateral synchronous occult disease is unknown. This study aims to describe the incidence of bilateral tonsillar carcinoma in early stage disease.
Methods:
The study design consisted of a retrospective cohort study of 120 patients with T1 or T2 primary tonsillar squamous cell carcinoma treated between 1995 to 2012. All patients were treated with primary radical surgical therapy and had the contralateral tonsil removed at the time of surgery. Data was extracted from an institutional review board approved department database. All cases were reviewed for evidence of an occult tumor in the contralateral tonsil.
Results:
Out of 120 patients, 3 patients were identified to have an occult primary cancer in the contralateral tonsil. This resulted in a 2.5% incidence of disease in this cohort of patients. Compared to the incidence of tonsillar carcinoma in the general population 2.1 x 10-5, (95% CI: 2 x 10-5, 2.2 x 10-5) this is significantly elevated.
Conclusions:
This is the first study attempting to establish the incidence of bilateral tonsillar carcinoma in a large cohort of early stage tonsillar carcinoma patients. Given the increasing use of transoral robotic surgery to treat these patients, it is important to be aware that there is likely a small but slightly elevated risk of contralateral occult disease.
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