Hypernephroma metastatic to the palatine tonsils.

Review of the literature discloses 76 cases of carcinoma metastatic to the palatine tonsil. Of these cases reported or mentioned, 51 were detailed sufficiently or occurred frequently enough to allow analysis. We add two new cases of hypernephroma, and also study the courses of patients with primaries of the stomach, breast, lung and melanoma and seminoma. Bilateral tonsilar involvement is found to be very common in melanoma and not uncommon in seminoma and adenocarcinomas of the stomach and breast. It is uncommon for bronchogenic carcinoma and hypernephroma to metastasize to both palatine tonsils. When laterality is present the left tonsil is more commonly involved than the right, except by melanoma. Regarding neoplastic involvement of the primary organ, the left side gives rise to malignancies more often than the right side. Only seminoma has a high incidence of other metastases. The mean time interval between development of the primary and the tonsillar secondary is one year or less in seminomas, bronchogenic carcinomas and adenocarcinomas of the stomach, but 2 1/2 years or more for adenocarcinomas of the breast and kidney and melanomas. The mean time of survival after appearance of the tonsillar metastasis is nine months or less, regardless of the cell type of the primary malignancy.