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Suggest Treatment For Papilloma On Tonsil

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Posted on Fri, 12 Feb 2016
Question: Today I was diagnosed with a papilloma on my one tonsil. My ENT did not seem concerned at all. Should I be concerned as all searches on the Internet are grim. I'm 29 a smoker and my husband has hpv with no current outbreaks.
doctor
Answered by Dr. Sumit Bhatti (2 hours later)
Brief Answer:
Wait & watch is fine. Otherwise excision biopsy, HPE, PCR tests for HPV/EBV

Detailed Answer:
Hi,

Thank you for your query.

1. Papillomas can be conclusively ruled out on tissue examination. Upload a clear close-up image. This lump can also be lymphoid tissue, a blocked tonsillar crypt or a minor salivary gland cyst.

2. An excisional biopsy (since the lesion is small) with a histopathology examination (HPE) would be ideal, however, the tonsil is known to bleed profusely with the slightest injury. That is why some doctors recommend a tonsillectomy (which is traditionally then done on both sides). Newer options are Radio-frequency and Coblation. If you have no problem with the tonsils otherwise, these are better options.

3. You may get a Neck Ultrasound done to look for any local lymph nodes. If these are absent, other causes such as active infections, tumours are highly unlikely.

4. If you have no symptoms, regular observation and follow up will help. If you have a foreign body sensation, tonsillectomy is an option.

5. One more option is to get a throat swab or scraping checked for viral DNA linked to oral cancers, such as HPV types 16,18 and Ebstein Barr Virus (EBV). (PCR -Polymerase Chain Reaction tests), If these are negative, there is no cause for worry. Vaccination is possible only for younger patients.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumit Bhatti (14 hours later)
How common are warts on tonsils? My dr didn't give me any options besides removing it in office or sedation. He left that up to me. But there was no immediate concern from him. I did have an infection of my gums on the opposite side of the mouth last week right before visiting with my ent and dentist.
doctor
Answered by Dr. Sumit Bhatti (10 hours later)
Brief Answer:
Not very common.

Detailed Answer:
Hi,

Thank you for writing back.

1. Warts on the tonsil are not very common, though HPV infection is common. Less than 5% people have tonsil warts or papillomas. Most being asymptomatic are not reported.

2. I would recommend a removal in the (minor) operation theatre as the tonsil is a very vascular structure, prone to bleeding at the slightest damage. This can be easily controlled in the operation theatre.

3. The gum infection must be controlled first. At the same time, the effect of medication on this tonsil lesion should be observed.

4. This is most likely to be benign, though the only way to prove this is to medicate an then remove for examination under a microscope.

5. Thus should be a minor procedure.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
Dr.
Dr. Sumit Bhatti

Otolaryngologist / ENT Specialist

Practicing since :1991

Answered : 2685 Questions

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Suggest Treatment For Papilloma On Tonsil

Brief Answer: Wait & watch is fine. Otherwise excision biopsy, HPE, PCR tests for HPV/EBV Detailed Answer: Hi, Thank you for your query. 1. Papillomas can be conclusively ruled out on tissue examination. Upload a clear close-up image. This lump can also be lymphoid tissue, a blocked tonsillar crypt or a minor salivary gland cyst. 2. An excisional biopsy (since the lesion is small) with a histopathology examination (HPE) would be ideal, however, the tonsil is known to bleed profusely with the slightest injury. That is why some doctors recommend a tonsillectomy (which is traditionally then done on both sides). Newer options are Radio-frequency and Coblation. If you have no problem with the tonsils otherwise, these are better options. 3. You may get a Neck Ultrasound done to look for any local lymph nodes. If these are absent, other causes such as active infections, tumours are highly unlikely. 4. If you have no symptoms, regular observation and follow up will help. If you have a foreign body sensation, tonsillectomy is an option. 5. One more option is to get a throat swab or scraping checked for viral DNA linked to oral cancers, such as HPV types 16,18 and Ebstein Barr Virus (EBV). (PCR -Polymerase Chain Reaction tests), If these are negative, there is no cause for worry. Vaccination is possible only for younger patients. I hope that I have answered your queries. If you have any further questions, I will be available to answer them. Regards.