Unexpected Tonsillar Carcinoma in a Sleep Apnea Patient – Is Routine Histopathology After Tonsillectomy Avoidable?

ABSTRACT

Tonsillectomy specimens are routinely sent for histopathologic evaluation to assess inflammatory process as well as to exclude occult malignancy. But nowadays many authors believe that routine microscopic examination of tonsillectomy specimen results in unnecessary cost and consumption of resources and time because of a low incidence of malignant tumor in unsuspected tonsils. In sleep surgery “healthy” tonsils are operated. We report on a case in which tonsillar carcinoma was detected after tonsillectomy for obstructive sleep apnea. The patient fortunately did not require any adjuvant therapy. A presented case of occult malignancy of normal size tonsil in the sleep apnea patient without any risk factors together with recent literature review support our recommendation: The routine histopathologic evaluation of surgically removed tonsillar tissue in the absence of preoperative risk factors is not necessary.