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77th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

24.05. - 28.05.2006, Mannheim

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Unexpected tonsillar carcinoma in sleep apnea patient

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  • corresponding author Jan Plzak - ENT Department, 1st Fac Med, Charles University, Prag, Tschechien
  • Jan Klozar - ENT Department, 1st Fac Med, Charles University, Prag, Tschechien
  • Michal Zabrodsky - ENT Department, 1st Fac Med, Charles University, Prag, Tschechien
  • Jan Betka - ENT Department, 1st Fac Med, Charles University, Prag, Tschechien

German Society of Otorhinolaryngology, Head and Neck Surgery. 77th Annual Meeting of the German Society of Otorhinolaryngology, Head and Neck Surgery. Mannheim, 24.-28.05.2006. Düsseldorf, Köln: German Medical Science; 2006. Doc06hno073

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/hno2006/06hno073.shtml

Published: September 7, 2006

© 2006 Plzak et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

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We report on a case in which tonsillar carcinoma was detected after tonsillectomy for sleep apnea. A man, 53 years old, suffering from moderate obstructive sleep apnea (AHI 29.5) was recommended for the surgical treatment. Uvulopalatopharyngoplasty with bilateral tonsillectomy was performed. Perioperative and immediate postoperative course was without extraordinary event. Microscopic examination of the left tonsillectomy specimen revealed the 2 mm nest of mucoepidermoid carcinoma, surrounded by an intact tonsillar tissue. Clinical examination two weeks after the surgery showed an asymmetry of the faucial isthmus with smooth dishing on the left side. MRI described suspected tumorous infiltration of the left pharyngeal wall (2 cm diameter) with enlargement of the regional lymph nodes in the level II. Biopsy from the suspected pharyngeal region under local and later under general anesthesia certified no evidence of malignant cells. Three month after the surgery there was no asymmetry of the pharynx based on both clinical examination and MRI. Sleep study six month after the treatment showed significant reduction of AHI (AHI 8.8). After two years the patient is still with no evidence of disease.

We hypothesize that the postoperative asymmetry of the pharynx could have been caused by inflammatory postoperative healing, although without any patient’s complaints.

In accordance with the literature reports we recommend routine histopathologic examination of tonsillectomy specimens in adults.

Supported by the Internal Grant of the Ministry of Health of The Czech Republic No. NR/9049 - 3.