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Suggest Treatment Unilateral Enlarged Tonsil On Right Side

Posted on Thu, 25 Jun 2015

Question: I have a unilateral enlarged tonsil on the right side. It has been this way for 2 months and has not changed after two rounds of antibiotics. I feel fatigued and can feel the enlarged tonsil hitting the back of my throat. One ENT that looked at it said it was a benign neoplasm but I read online these are very rare. Is there a chance this is lymphoma? Or could turn into lymphoma? How soon do I need to have a tonsillectomy?

Answered by Dr. Heera Lal Poonia (2 hours later)

Brief Answer:
yes, go for tonsillectomy

Detailed Answer:
Dear XXXX, welcome to HCM and thanks for choosing us. I have seen the uploaded image.

I share your concerns about enlarged tonsil and it's persistence even after courses of antibiotics. Although cancer is rare in tonsils, but it is still a possibility with your history as it is unilateral enlargement, no response to the treatment . Opinion of your ENT doctor could be true.

You might have cancer of tonsils itself or it may be a reactionary hyperplasia to a nearby cancer of some lymph node in neck. I would advise you to go for tonsillectomy and it's biopsy urgently. If it was cancer of tonsils itself, it would be a final treatment. If it is a reactive cancer it would be a diagnostic tonsillectomy and will help us in identifying the cause behind it and finally treating the condition.

I hope my reply will help you. Please write to us if you have any other question related to this condition. Thanks.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Heera Lal Poonia (15 hours later)

I am scheduled for a tonsillectomy July 9th, do you think this is soon enough? If is it cancer, do you think waiting until JUly 9th could make cancer worse?

I have no enlarged lymph nodes and no throat or neck pain. My fatigue comes and goes, seems to be worse in morning and afternoon. What do you think is causing the fatigue? It was about 6-8 wks ago that I had a cold and enlarged tonsil, cold went away but enlarged tonsil did not. I have had mono in the past but recent monospot is neg. I have a normal CBC and Chem 7 except for high bili 1.5. I have had low WBC's in the past but CBC done last week showed normal WBC's.

Answered by Dr. Heera Lal Poonia (3 hours later)

Brief Answer:
yes you can wait till 9th July. however remain alert

Detailed Answer:
Dear XXXX, welcome again.

Thanks for the details and follow up queries. Tonsillectomy scheduled for 9th July is in my opinion soon enough. However keep observing the size and any other changes in the enlarged tonsil. If it remains at same size, there should not be a problem. If you notice any other symptom like swelling in neck or any lymph node enlargement in any part of the body, immediately consult your doctor.

Fatigue, which you have , could be due to rounds of antibiotics you have taken and slightly raised bilirubin levels. You will notice improvement in due course of time, however if it worsens, please contact your treating doctor urgently. Take good diet, do some exercises in morning to get rid of the fatigue.

I hope my reply will help you. Please feel free to contact us for more information and follow up queries. I wish you good health and rapid recovery from the illness you have. Thanks. Kindly provide a feedback.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Heera Lal Poonia (2 days later)

Thank you and I will keep you posted. Do you think steroids could help?

Answered by Dr. Heera Lal Poonia (12 minutes later)

Brief Answer:
steroids not recommended

Detailed Answer:
Dear XXXX, welcome again.

Thanks for the follow up. Steroids may help as they have anti inflammatory action but I would not recommend steroids because
They have several side effects
You have very localised inflammation
Steroids will also not be able to give final relief

So better to go for excision and biopsy which is scheduled on 9th July.

Thanks and 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. Prasad