Cancer of Tonsil - PET scan Question


Hi all, 

I'm the caregiver/medical advocate for my husband who was diagnosed with Stage iV, Tonsil with METS to Lymph Node. We found the lymph node first which was 3.5 cm by 4.  We had an excellent ENT who has Oncology Exp. And went from AnitBIOMeds/Scope/MRI/Biopsy/PET and then Surgical Biopsy with Option for Neck Dissection if the primary was found. It was found, the tonsil, which was 3.0 cm.  So his surgery removed the tonsil, clear margins and then robotic neck dissection to remove 44 lymph nodes, two which were SCC. No nerve damage, or complicated intricacies with veins etc. His cancer is SCC, HPV Positive. And we go to his Radiation Oncologist on Monday for consult. This pretty much sums up the last 7 weeks. Which feels like a very expedient timeline and we are grateful. 

I had a couple of quesitons related to other's experience with PET scans. I am surprised that a PET scan did not pick up the lesion/tumor in his tonsil. Is that common? Also, is it common with SCC HPV+ to not take both tonsils? These are questions that I just haven't had time to ask surgeon as of yet. His path report didn't come back until yesterday, and we could only speak to the Phy. Asst. 

I am pretty sure I'm going to, and my husband is going to be a regular here for a bit. So inspiring to see the stories shared here and grateful to all for a place like this to ask for help and support. 

Thank you! 


  • bebo12249
    bebo12249 Member Posts: 181 Member
    A PET scan, like almost all

    A PET scan, like almost all other diagnostic tests can miss a disease, that is they can return a negative result even in the presence of disease. It would be a falsely negative test. A relatively new growth, for example, may not be detected by a PET. There are also other factors that can cause false negatives and these vary by the test, the disease, etc. As for taking both tonsils, there is not clear agreement. Some recommend both but my surgeon recommended taking only the diseased tonsil. There are arguments + and - for each approach. Bill

  • Curlyn
    Curlyn Member Posts: 189
    Mine was bot on the very far

    Mine was bot on the very far right, with affected lymph node. Bot cancer ( I was told by my surgeon) is usually considered bilateral, however, because it was so far to the right and only right lymph node affected, did not have dissection on the other side, when tiny primary removed. I am also only having rads on that one side. I'm good /c that. Good luck!