Why are tonsil tumors easily misdiagnosed?

Tonsillar tumor is a relatively rare disease among tumors. Tonsillar tumors are divided into several types, including squamous cell carcinoma, lymphoma, reticulocyte malignant tumor, vascular malignant tumor, etc. Among them, squamous cell carcinoma has the highest incidence. Generally, tonsillar tumors are more common in middle-aged people. Tonsillar sarcoma is mostly benign and more common in young people. Once symptoms of discomfort in the throat appear, you must go to the hospital for examination as soon as possible and receive symptomatic treatment.

Diagnostic tests:

1. The medical history should pay attention to the presence of pharyngeal obstruction, foreign body sensation, atypical tonsillitis, unilateral pharyngeal pain, unilateral tonsil enlargement, bad breath, etc.

2. (1) Examination of the oropharynx, paying attention to the shape and movement of the soft palate, the size and shape of the tonsils, and their relationship to surrounding tissues. Palpation should be performed to understand the local hardness and range. In case of suspicious condition or ulcer, a biopsy should be performed; (2) Check whether the submandibular and cervical lymph nodes are enlarged. Pay attention to whether there is distant metastasis.

3. During the examination, pay attention to changes in blood count and the presence of immature cells.

4. X-rays include chest and skeletal x-rays or CT of symptomatic areas.

【Overview of Misdiagnosis】

The misdiagnosis of tonsil malignant tumors is mainly manifested in the delay of diagnosis. Although patients in the middle and late stages are easy to diagnose, they have lost the opportunity for the best treatment. Although there are not many reports on misdiagnosis of tonsillar malignant tumors, most patients in clinical practice have experienced varying degrees of misdiagnosis and received non-targeted treatments before being diagnosed.

[Misdiagnosis range]

1. Acute tonsillitis: Acute tonsillitis is the most common disease of the tonsils. Upper respiratory tract infection and other oral infections are also often complicated by acute tonsillitis. Therefore, once a patient visits a doctor with sore throat or foreign body sensation in the throat, the doctor will often consider inflammation first.

2. Peritonsillitis: Tonsillar lymphosarcoma in young people is often manifested by congestion and diffuse swelling of the tonsils. If the patient has had sore throat before seeing a doctor, and it lasts for a long time, or has a history of recurrent attacks, it may be misdiagnosed as peritonsillitis.

3. Chronic tonsillitis: Throat pain and foreign body sensation in the throat recur or persist, and anti-inflammatory treatment is generally ineffective. This is the characteristic of chronic tonsillitis. Patients with malignant tonsil tumors often seek medical treatment with these symptoms. Therefore, when there are no obvious local ulcers, necrosis or other signs of advanced malignant tumors in the tonsils, it is easy to be misdiagnosed as chronic inflammation. Sometimes, even though lymph nodes are swollen in the neck, there are no special manifestations in the tonsils and they may still be misdiagnosed as inflammation due to lack of vigilance.

【Causes of misdiagnosis】

1. Lack of vigilance against cancer: One of the reasons for the misdiagnosis of this disease is that the patients lack vigilance against malignant tumors, fail to make a serious analysis of the early clinical manifestations similar to inflammation, and are satisfied with the diagnosis of common diseases.

2. Special location of the lesion: The reason why early diagnosis is difficult is that the lesions are small. Lesions hidden in the groove of the lingual tonsil and below the palatine arch are often covered by the raised tongue and are not discovered in time.

3. Lack of proper palpation: Routine physical examination of tonsils is often based on visual inspection only, and palpation is rarely performed. Therefore, even if there are malignant lesions that have formed nodules, they are easily missed due to lack of timely palpation.

4. Early metastasis with no obvious signs: The tonsils are richly supplied with blood and have extensive lymphatic connections with the neck. In addition, the surrounding tissues are often in a state of activity and contraction due to movements such as talking and swallowing, which has certain similarities with nasopharyngeal carcinoma. Therefore, when the primary lesion is very small, cervical lymph node metastasis may appear early and even become the patient's only complaint or only symptom. Therefore, local examination of the tonsils is often ignored.