RESUMO
Tonsillar carcinoma is the most common cancer of oropharynx. Panendoscope guided biopsy has been estabilished as a diagnostic and therapeutic procedure for patients with cervical nodes from metastasis of unknown origin. There is a controversy about regarding bilateral tonsillectomy as the standard procedure. In studies where bilateral tonsillectomy are routinely performed for diagnosis of unknown primaries, the rates of occult tonsillar carcinoma could be as high as 40%. On the other hand, the incidence of synchronous tonsil carcinoma is exceedingly rare with less than 15 reports in the English literature although synchronous, metachronous carcinomas are more common in head and neck carcinomas than in other sites because the risk factors for the development of carcinomas are shared between the two. We report two cases of bilateral tonsillar carcinoma with literature reviews. In these particular cases, they present an aggressive clinical feature despite small size of the primary lesion. A careful, systemic work up should be performed in bilateral tonsillar carcinoma.