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CC BY 4.0 · Indian J Med Paediatr Oncol
DOI: 10.1055/s-0045-1813689
Case Report

Hepatocellular Carcinoma Presenting with Tonsillar Metastasis: A Case Report with a Review of Literature

Authors

  • Annie Francis

    1   Department of Medical Oncology, Caritas Hospital and Institute of Health Sciences, Kottayam, Kerala, India

  • Boben Thomas

    1   Department of Medical Oncology, Caritas Hospital and Institute of Health Sciences, Kottayam, Kerala, India

  • Unni S. Pillai

    1   Department of Medical Oncology, Caritas Hospital and Institute of Health Sciences, Kottayam, Kerala, India

  • Thomas Babu

    1   Department of Medical Oncology, Caritas Hospital and Institute of Health Sciences, Kottayam, Kerala, India

  • Diya Jacob

    2   Department of Pathology, Caritas Hospital and Institute of Health Sciences, Kottayam, Kerala, India

Funding None.
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Abstract

Hepatocellular carcinoma (HCC) is the most common primary liver malignancy, with extrahepatic metastases occurring in approximately 5 to 15% of cases. Metastases to tonsils are exceedingly rare and can pose a considerable diagnostic challenge. We present a rare case of a 77-year-old male patient who presented with a tonsillar mass, which following tonsillectomy and histopathological analysis was identified as a metastatic lesion. Subsequent evaluation revealed multifocal HCC with extrahepatic spread to the tonsils and lymph nodes. The patient was initiated on immunotherapy and had an excellent treatment response. This case underscores the importance of considering metastatic disease in the differential diagnosis of atypical head and neck lesions in patients with risk factors for HCC. Early diagnosis and timely intervention can positively impact survival, even in cases of advanced malignancy with atypical presentations.

Keywords

hepatocellular carcinoma - tonsillar metastasis - extrahepatic spread - case report - rare presentation

Data Availability Statement

The data for the current study are available from the corresponding author on reasonable request.


Authors' Contributions

A.F.: Concept, data collection, and manuscript writing. B.T.: Case management, review, and editing. U.S.P.: Conceptual guidance and manuscript review. T.B.: Oncology input and literature review. D.J.: Histopathology and immunohistochemistry analysis.


Patient's Consent

Written informed consent was obtained from the patient for publication of this case report and any accompanying images.




Publication History

Article published online:
15 December 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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