Authors |
Year |
Origin |
Study Design |
N |
Workup |
N tonsillectomy |
Tonsillectomy Pickup |
Synchronous/Contralateral |
Complications |
Recommendations |
Podeur et al19
|
2020 |
France |
RS |
63 |
Negative
Ex, CT, PETCT, endoscopy |
47 (UL/BL) |
26% (59% if HPV positive) |
CL
8.3% |
6% for tonsillectomy - Haemorrhage - return to theatre |
Extended workup BL tonsillectomy +/- TBM HPV positive |
Lee et al12
|
2020
|
USA
|
RS cohort
|
180
|
Negative ex and flexible laryngoscopy/mirror
HPV status.
PETCT (73.9%) prior to direct laryngoscopy with Biopsy
|
87 (36 BL/ 51 UL)
|
Tonsillectomy
32.2%
(28/87)
Overall tonsil: 51/92: 55.4%
|
CL 2% (2) BL 6% (6) (location not specified)
|
|
Tonsillectomy and TORS TBM if negative
|
Rokkjaer & Klug23
|
2018
|
Denmark
|
RS
|
211
|
Tonsillar Ca pts
|
180 BL, 31 UL with CL Biopsy. 14 Biopsy
|
|
3.3% (7/211) Synchronous BL
2.3% (4/171) CL (2 had dysplasia)
|
|
BL tonsillectomy in suspected/proven tonsillar cancer and CUP
|
Saber et al24
|
2017 |
Denmark |
RS |
1119 |
Tonsillar
Ca pts |
12 Bi tonsillar SCC. 9 of which were CUP |
|
Bilateral 9%
(2012-2014 when tonsils totally embedded) particularly HPV. !% whole
study time |
|
Bilateral tonsillectomy |
Kothari et al25
|
2007
|
UK
|
RS
|
24
|
MRI if negative PETCT
|
BL tonsillectomy in 22
|
|
BL 22.7% (5/22)
2 had IL pos findings PETCT
|
|
BL tonsillectomy
|
Koch et al26
|
2001 |
USA |
Case series |
41 |
|
|
39% (16) |
12.5% CL (2/16), 12.5% BL (2/16) |
|
BL
tonsillectomy |
Tanzler et al5
|
2014 |
USA |
RS |
156 |
Negative Ex,
Ix and PE |
71 |
39% (28/71) |
6% (2/34) BL (not all had CL sampled) |
|
Palatine tonsillectomy, consider BL |
Cianchetti et al14
|
2009
|
USA
|
RS
|
236
|
Negative workup: Ex,CXR, CT/MRI.+/- FDG-DSPECT/FDG PET. Then PE directed
Biopsy.
Mix negative and positive
|
IL or BL 79
|
44.3% (35/79)
Overall 46.8% (59/126)
|
4.76% (6/126) synchronous (2.8% BL tonsils 1/59 with tonsillar
Cancer)
|
|
UL or BL should be inc in workup
|
McQuone et al11
|
1998
|
USA
|
RS
|
37
|
Negative Ex and radiological, endoscopy
|
IL7, BL 16: 23
|
39% (9/23)
|
11.1% (1/9) BL with tonsillectomy, 9.1% overall (1/11)
|
|
BL PT
n=2 (100%) of positive Biopsy pts had palpable asymmetry
|