Diagnosis of malignant neoplasm of the palatine tonsil by incisional biopsy, experience at the San Juan de Dios Hospital.

Abstract

Introduction: Cancer of the tonsils is mainly due to squamous cell carcinoma (75%) and lymphoma. Squamous cell carcinoma reports a HPV rate of 43%. Diagnosis is performed through biopsy, where tonsillectomy is the gold standard. There are no studies on the usefulness of incisional biopsy as a diagnostic method. This study presents benefits such as reduced resource expenditure, fewer complications, and shorter waiting times. Objectives: Estimate the effectiveness of incisional biopsy for the diagnosis of tonsillar cancer in patients with high clinical suspicion, describe the presence of the p16 marker in patients with squamous cell carcinoma. Materials and Methods: Retrospective descriptive study. Sample of 49 adult patients with a high suspicion of tonsillar cancer, undergoing incisional biopsy at the Hospital San Juan De Dios between 2016 and 2022. Results: Among patients with palatine tonsillar cancer, 95% were diagnosed with incisional biopsy (44% squamous cell carcinoma and 40% lymphoma). 6 patients did not achieve a diagnosis with this technique. Out of the incisional biopsies performed in the outpatient clinic, only 1 (2%) was insufficient. Presence of p16 was described in 77% of patients with squamous cell carcinoma. Discussion: There is a similar distribution between lymphoma and squamous cell carcinoma. There is a high presence of HPV in squamous cell carcinoma of the tonsil. Conclusions: Incisional biopsy in cases of suspected palatine tonsillar cancer appears to be a good alternative due to the high number of diagnoses obtained.