Tonsillary metastasis from breast cancer: a case report

Introduction The palatine tonsils are a very rare site for metastases from breast cancer. Around 10 cases have been described in the literature so far.

Case report A 55-year-old female patient presented with a left submandibular swelling since approximately four weeks.

The underlying disease is an advanced invasive ductal breast cancer on the right side with currently multiple metastases. She underwent neoadjuvant chemotherapy and ablatio mamma on the right as well as another chemotherapy. Last held until September 2020. Upon presentation, the patient was under ongoing antibody therapy.

The ENT examination revealed a left submandibular swelling, which represented as two suspicious lymph nodes in the ultrasound. Enoral the left tonsil was comparably denser without visible asymmetry to the other side.

We performed a panendoscopy with samples taken from the left palatine tonsil together with a removal of the two left lymph nodes.

Results Histopathology showed metastases of an invasive lobular breast cancer in the left palatine tonsil as well as in the lymph nodes. The estrogen receptor was <10%, IRS 3 and the progesterone receptor was <10%, IRS 3. Her2 was negative and Ki-67 approx. 20%.

The requested previous histopathology showed an estrogen receptor of 9/12 IRS and a progesterone receptor of 9/12 IRS. Her2neu was negative (1+) and Ki-67 was not determined.

Conclusion Although breast cancer is the most common cancer in women, tonsillar metastases are very rare. If metastases in the ENT area are suspected, a thorough panendoscopy should therefore be performed with attention to the tonsils.

Publication History

Article published online:
24 May 2022