Ask a doctor on the topic of Otorhinolaryngology

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January 5, 2015 | 15,00 EUR | answered by Christian Welsch

Dear Sir or Madam,

I have the following problem. About 6 years ago, I had a year with several cases of tonsillitis, which always subsided. Even back then, I had a pea-sized lump on my tonsil. It was checked by my ENT doctor in 2013 and deemed harmless, she said it could be a change due to the inflammation.
Now I have noticed that the lump has become slightly larger and asymmetrical. I had a tonsil irritation 2 weeks ago, but it was gone after 2 days and otherwise I have no problems. I also have tonsil stones frequently, I must say.

I am 23 years old, I do not smoke, I drink alcohol about 2 times a year. Now I am afraid that it could be tonsil cancer? Can it be assessed externally without surgically removing the tonsils (I do not want to undergo any surgery, especially since I am very afraid of postoperative bleeding)?

I will be abroad for 6 weeks, should I try to get an appointment on Tuesday? Or can I wait for 6 weeks?

Best regards and a Happy New Year

Christian Welsch

Dear questioner, I think that an ENT check-up is necessary. The more infections pass through the tonsils, the more scars and cysts develop over the course of life. Surgery is performed in Germany if one has had purulent tonsils more than three times a year for several years or if there is an episode of more than 5 purulent infections in a year. However, surgery is always an individual decision.
You are too young for cancer and do not have relevant risk factors (heavy drinking and smoking). The other two risk factors (poor oral hygiene and HPV infections) only become relevant in later years. In the case of cancer (squamous cell carcinoma), one would also expect one-sided neck pain.
Rarely, malignant lymphomas can occur in the tonsils, which manifest as asymmetry of the tonsils, weight loss, and night sweats.
Do you have any questions? Regards, Welsch