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Have cyst in tonsil. Should I consult further? Malignant chances?

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ENT Specialist
Practicing since : 1991
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I was told that I have tonsilar cyst about a year ago. Ive noticed that its still there on my left tonsil.
Should I have it examined again by ENT or leave it along. Is it a benign condition ?
Posted Fri, 13 Jul 2012 in Ear, Nose and Throat Problems
Answered by Dr. Sumit Bhatti 1 hour later

Thank you for your query.

1. The appearance, size, exact location of the cyst, behavior, growth rate or a close up image will help give a better understanding as to the nature of this cyst. You may share a close-up image here.

2. Sometimes the underlying cause is a Tonsillolith or a blocked tonsillar crypt. Tonsilloliths are concretions of food particles and pus lodged in the natural crypts of the palatine tonsils. The largest crypt is known as the crypta magna and is located near the upper pole of the palatine tonsil.

3. When we swallow, our palatine tonsils rub against the food bolus and pick up food particles. This food debris decays there while it is analysed for antigens, foreign bodies and organisms by the lymphoid tissue which forms the bulk of the tonsils. Below the age of five years, this is especially important in the deveopment of immunity.

4. A differential will include mostly benign conditions such as a tonsillolith, area of lymphoid hypertrophy, accessory lymphoid tissue, inflamed minor salivary gland tissue, abscess in the peritonsillar space. However this would be unusual without local inflammation and lymph node tenderness in the neck.

5. The simplest course of action will be a course of antibiotics, anti-allergics, anti-inflammatory agents and medicated gargles. If there is no improvement, an excision biopsy and a histopathological examination which will reveal the true diagnosis of the cyst. As long as it is a limited mass, surgery will be minor. You may follow up with the HPE report here.

7. I must emphasize that the chance of a cancerous growth or cancerous change at your age is rare. This also means that you may leave it alone and keep it under observation on a long term basis.

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

Above answer was peer-reviewed by
Follow-up: Have cyst in tonsil. Should I consult further? Malignant chances? 20 hours later
I went to an Ent specialist today and after he scoped my throat he said that I have z granuloma of the vocal process.
He put me on antacid and told me to return in a month.
Could granuloma be mistaken for vocal cord cancer. And will I need biopsy to rule it out.
Answered by Dr. Sumit Bhatti 4 hours later

Thank you or writing back.

1. Vocal process granulomas are usually discovered by chance during laryngoscopy, such as yours. They are benign. Do you have any symptoms?

2. The exact cause must be determined. Chronic acid reflux or voice strain are common causes of irritation which cause vocal process granulomas.

3. Biopsy is not needed at present. Medical treatment aimed at reducing this granuloma is needed for a few months. You may follow up with regular endoscopies if you want to keep track of this granuloma. Biopsy is only reserved for cases where the granuloma does not heal or starts growing quickly. Being a small lesion, biopsy usually results in complete excision.

4. Surgical removal without correcting the cause will result in recurrence. Treating the underlying cause helps avoid unnecessary surgery, as the granuloma will heal on its own.

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

Above answer was peer-reviewed by
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