What could be the possible cause of asymmetrical posterior tonsil pillar?

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern. In the images (attachment removed to protect the patient’s identity), the entire tonsil and oropharynx are not visible. But, the visualized areas do not show any sinister growth or ulceration, and the uvula appears central. Tonsils can persist in about 10 to 15 percent of adults, however, when they are asymmetrical (i.e. of different sizes) there is a risk of underlying cancer. Hence, it is of utmost importance to see both tonsils together along with the whole throat and some close-up images of the tonsils individually. If you could provide these images, I would be able to make a more accurate and comprehensive diagnosis. Also, can you kindly elaborate on any other throat symptoms, any tonsil surgery in the past, and smoking or alcohol history? And any history of significant diseases or treatments including cancer.

Thank you.

Differential diagnosis:

Asymmetric tonsil- investigations to rule out tonsillar cancer.

Treatment plan:

I would suggest you keep a close watch and look for any new changes in shape, size, or ulceration. Follow up with details and images.

Regarding follow-up:

I would suggest if any new changes in shape, size, or ulceration are found, follow up with further details and images.

Hello,

Welcome back to icliniq.com.

I read your query and can understand your concern. Thanks for the image (attachment removed to protect the patient’s identity), I would suggest the probabilities are of tonsilolith but cancer also needs to be ruled out.

Differential diagnosis:

The probabilities are of tonsilolith but cancer needs to be ruled out.

Treatment plan:

I would suggest you maintain oral hygiene and active surveillance.

Regarding follow-up:

I would suggest you follow up with a comprehensive history for reaching a definitive diagnosis as already mentioned along with the clinical findings. There is a whitish area on the tonsil which is unfortunately not very clear and needs careful evaluation.