title: Tonsillar metastasis of gastric cancer.
abstract: Metastasis from a malignant tumor to the palatine tonsils is rare, with only 100 cases reported in the English-language literature. Tonsillar metastasis from a gastric cancer is very rare. We report here a case of palatine tonsillar metastasis after gastric cancer surgery. The patient was an 88-year-old woman who had gastric cancer with abdominal wall invasion. She had undergone a distal gastrectomy with abdominal wall resection and D2 lymph node dissection. Histologically, the tumor was primarily a moderately differentiated adenocarcinoma. It was stage IV (T4, N1, M0) using TNM clinical classification. The patient developed pharyngeal discomfort and abdominal pain and was hospitalized during the follow-up period, 1 year 9 months post-operatively. Multiple lung metastases, Virchow's lymph node metastasis, and adrenal metastasis were observed. A mass of 2.5 cm was also observed in the right palatine tonsil. It was diagnosed as a moderately differentiated adenocarcinoma, a metastasis from gastric cancer. There was a concern of asphyxiation due to hemorrhage of the tumor; however, the tumor dislodged approximately 10 days after biopsy and tonsillar recurrence was not observed. The patient died 1 year 10 months post-operatively. In the literature there are cases with tonsillar metastases where surgical treatment, radiotherapy, and chemotherapy were performed and extension of survival was seen. Tonsillar metastasis is a form of systemic metastasis of a malignant tumor, and there is a high risk for asphyxiation from tumor dislodgement or hemorrhage. Thus, it is important to recognize tonsillar metastasis as an oncologic emergency.
authors.forename: Emi
authors.initials: E
authors.lastname: Yamaguchi
authors.forename: Masaaki
authors.initials: M
authors.lastname: Uchida
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Makino
authors.forename: Maromi
authors.initials: M
authors.lastname: Tachibana
authors.forename: Takashi
authors.initials: T
authors.lastname: Sato
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Kousaku
authors.initials: K
authors.lastname: Kawashima
authors.forename: Asuka
authors.initials: A
authors.lastname: Araki
authors.forename: Riruke
authors.initials: R
authors.lastname: Maruyama