How would you manage a p16 positive small cell carcinoma of the tonsil?

Assuming it is indeed small cell (undifferentiated, neuroendocrine pathological features), extrapulmonary small cell cancer rarely metastasizes to the brain as venous drainage to the brain must first go through the lungs and produce subclinical lung metas. Therefore, there is a very low rate of brai...

Agree with Dr. @Dr. First Last. If it is truly a small cell carcinoma, I would recommend treatment with chemoRT (or surgery for lower grade neuroendocrine tumors) as discussed here. There is really no role for the use of PCI in this setting as Dr. Eisbruch mentioned. I would, however, consider expan...