Metastasis of hepatocellular carcinoma to the palatine tonsil – a case report

<b>Introduction:</b> Tumor metastases to the palatine tonsil are rare, accounting for only 0.8% of all malignant tumors of the palatine tonsil. According to the National Cancer Registry, 743 new cases of malignant tumors of the palatine tonsil (C09) were detected in Poland in 2021, including 526 cases in men and 217 cases in women. This paper describes a rare case of hepatocellular carcinoma (HCC) metastasis to the palatine tonsil in a 48-year-old male patient.<b>Case study:</b> The patient presented to the Department of Otolaryngology, Head and Neck Surgery at the Medical University of Warsaw (MUW) complaining of a sensation of obstruction within the throat. Thirteen months earlier, the patient had undergone liver transplantation due to cirrhosis caused by chronic hepatitis C virus (HCV) infection, which was complicated by HCC. The patient was referred for urgent computed tomography (CT) of the head which revealed a tumor in the right palatine tonsil. An urgent bilateral tonsillectomy was performed. Postoperative histopathological examination confirmed a metastasis of HCC.<b>Conclusions:</b> The pathway of HCC metastasis to the oral cavity is unclear, with one hypothesis suggesting the migration of cancer cells bypassing the lungs via paravertebral Batson veins. The mean survival time of patients with metastases to the tonsil is approximately 9 months regardless of the primary tumor site, and the mean survival time after HCC metastasis to the oral cavity is 21 weeks.