Author(s)
Tyler A. Janz BS
Ramamoorthy Nagasubramanian MD
Julie L. Wei MD
Affiliation(s)
University of Central Florida College of Medicine
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to understand the histological types of tonsillar malignancies as well as understand the common patient demographics and treatment modalities of these patients. Finally, the participants should be able to understand the survival outcomes of pediatric patients with tonsillar malignancies. Objectives: To examine the different types of pediatric tonsillar cancers and review the demographics, management, and survival of these patients. Study Design: National population based retrospective review using the Surveillance, Epidemiology, and End Results (SEER) database. Methods: Pediatric patients in the SEER database were included from 1973-2014 based on a diagnosis of tonsillar malignancy using the ICD O-3 tonsil primary site codes of: C09.0, C09.1, C09.8, and C09.9. Patients were included from ages 0-18 years. Additionally, we present a case of pediatric natural killer (NK) cell tonsillar lymphoma diagnosed and treated at our hospital. Results: One hundred forty-one cases of tonsil cancer were identified. The mean age at diagnosis was 9.9 years (SD: 5.1, range: 0.0-18.0). Ninety five (67.4%) patients were male and 116 (82.3%) had unilateral malignancies. Burkitt lymphoma (32.6%) followed by diffuse large B cell lymphoma (DLBCL) (27.0%) were the two most common histological types of tonsillar cancers. 79.4% of patients received chemotherapy and 81.6% received surgery as a part of their care. The 5 year disease specific survival rate was >90% for patient cohorts diagnosed from 1984-1993, 1994-2003, and 2004-2014 as compared to 64% for patients diagnosed from 1973-1983 (p=.01). Conclusions: Pediatric primary tonsil cancer occurred most commonly in adolescent males and usually presents as a unilateral mass. Lymphoma remains the predominant histological type of cancer. Most patients are likely to receive surgery and chemotherapy. Survival rates for pediatric patients with tonsillar cancer are excellent.