Clinical Presentation of Malignant Tumours of Tonsil and its Association with Unilateral Enlarged Tonsil in Different Age Groups

Abstract

Objective:To determine different clinical presentations in tonsil malignancy with unilateral enlarged tonsil (UET) in different age groups. Materials and Methods:This descriptive cross sectional study was carried out from 2007 to 2014 in Social Security Hospital Islamabad (allied with Islamabad Medical and Dental College) and in Holy Family Hospital Rawalpindi.80 patients underwent tonsillectomy suspected of tonsil tumour with tonsil asymmetry. In Group I patients were of 3-12 years and in group II, of 13 and above. Clinical assessment was done for any Regional and systemic disease.After tonsillectomy, difference in tonsil size was recorded on gross examination and then sent for histopathology. Statistical evaluation was done by using SPSS 16. Results: In group I predominant symptom was bilateral (B/L) cervical lymph node enlargement, 32(82%) along with UET. Majority of patients (82.5%) with clinically enlarged tonsil also showed enlargement in gross. Reactive hyperplasia was seen in 2 and lymphoma in 7 on histopathology. In group II Predominant clinical features were cervical lymphadenopathy, recurrent sore throat, headache, nasal obstruction, cough, earache and postnasal drip. 87.5 % of clinically enlarged tonsil showed enlargement in gross examination.Histopathology revealed lymph adenitis in 30, Squamous cell carcinoma (SCC) in 5 and B cell lymphoma in 2. Conclusion: Tonsillectomy must be done in UET to rule out malignant tumour of tonsil if accompanied by specific symptoms that could lead to tonsillar malignancy especially in adults.