ArticleFrontiers in oncology2026
Tonsillar metastasis from hepatocellular carcinoma: a case report and literature review.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Tonsillar metastasis from hepatocellular carcinoma (HCC) is extremely rare. We report an 84-year-old man with chronic hepatitis B who presented with a right-lobe HCC and portal vein tumor thrombosis. Three months after diagnosis, intrahepatic metastases were treated with transarterial chemoembolization and lenvatinib. Twenty-three months later, he developed blood-tinged sputum; imaging and laryngoscopy revealed a left tonsillar mass with concurrent pulmonary and hepatic progression. Tonsillectomy yielded an undifferentiated carcinoma lesion. Compared with the primary tumor, the tonsillar metastasis lost hepatocyte specific antigen (Hep Par-1) and Arginase-1 expression, showed a markedly elevated Ki-67 index (80%), but retained Glypican-3 and heat shock protein 70 (HSP70). A diagnosis of metastatic HCC was favored based on integration of clinical history, laboratory findings, and pathological immunohistochemistry. In HCC patients, any unusual head and neck lesion warrants suspicion of metastasis; a multi-marker panel is critical for diagnosis, as loss of Arginase-1 does not rule out HCC.
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