Unexplained Oral Growths: When to Seek Medical Advice - Otolaryngology

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Unidentified lesions in the oral cavity?


I'm sorry, the question is a bit long.
Last August, I experienced a fever and swelling and pain around my throat and tonsils that lasted for about a month.
I went to the hospital for examination, but the doctor could not determine the cause.
Later, I noticed swelling near my tonsils and suspected tonsillitis.
After researching, I learned that if tonsillitis lasts more than a week, there is a high possibility of a bacterial infection.
I informed the doctor who treated me at the hospital, but he said it didn't look like tonsillitis and that my tonsils might have always been that swollen.
However, he prescribed antibiotics for me, and by the third day, my fever subsided and I haven't had a fever since.
I'm not sure if the antibiotics were effective or if it was just coincidental that my fever resolved at that time.

After the fever subsided, I noticed white protrusions in my mouth near the tonsils.
I consulted three different ENT specialists, and they all said there was nothing serious, just to monitor it and that it didn't look concerning.
However, the white protrusions have not decreased in size, and occasionally they cause some pain when they hang down.
If they are not hanging down, as shown in the photos, there is not much pain, but I still feel a foreign body sensation.

Recently, a friend mentioned that it looks like cauliflower, but I'm worried that going for another consultation might be a waste of medical resources, especially since three doctors have already visually assessed it.
The issue is that it has been almost a year since the initial tonsil symptoms.

Hong Cha, 30~39 year old female. Ask Date: 2017/04/24

Dr. Zheng Jueyi reply Otolaryngology


Hello: Initially, it appears to be a papilloma.
If it continues to grow, it is recommended to visit a hospital for further examination or surgical removal for biopsy.
Wishing you safety and health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2017/04/24

More Info


When it comes to unexplained oral growths, particularly in the context of your symptoms and history, it’s crucial to approach the situation with caution and a proactive mindset. Your experience with fever, throat swelling, and the subsequent discovery of white protrusions near your tonsils raises several important considerations.

Firstly, the initial symptoms you described, including fever and throat pain, could have been indicative of an infection, such as tonsillitis or pharyngitis. The fact that you were prescribed antibiotics suggests that your physician suspected a bacterial infection, which can often lead to inflammation and swelling of the tonsils. However, the lingering white protrusions you’ve observed are concerning, especially since they have not diminished in size over the past year.

The white growths could represent a variety of conditions. They might be tonsillar crypts, which are normal anatomical features of the tonsils where debris can accumulate, leading to the formation of tonsil stones. Alternatively, they could be indicative of chronic tonsillitis or even a more serious condition, such as a benign or malignant neoplasm. The description provided by your friends, comparing the growths to cauliflower, could suggest a condition known as papillomatosis, which is characterized by the presence of multiple benign growths.

Given that you have already consulted three different ENT specialists who have not identified any serious issues, it’s understandable to feel hesitant about seeking further medical advice. However, the persistence of the symptoms, particularly the pain and the sensation of an obstruction, warrants further investigation. It is essential to ensure that these growths are not indicative of a more serious underlying condition.

Here are some recommendations on when to seek further medical advice:
1. Persistent Symptoms: If the white protrusions continue to cause discomfort, pain, or any changes in swallowing or breathing, it is essential to consult a healthcare provider. Persistent symptoms that do not resolve over time should always be evaluated.

2. Changes in Appearance: If the growths change in size, shape, or color, or if you notice any new symptoms such as bleeding, difficulty swallowing, or significant pain, these are red flags that should prompt immediate medical attention.

3. Second Opinion: If you feel uncertain about the evaluations you have received, seeking a second opinion from another ENT specialist or an oral surgeon may provide additional insights. Sometimes, a fresh perspective can lead to a different diagnosis or treatment approach.

4. Biopsy Consideration: If the growths remain unchanged but continue to cause concern, discussing the possibility of a biopsy with your healthcare provider could be beneficial. A biopsy would allow for a definitive diagnosis and rule out any malignancy.

5. Regular Monitoring: If you choose to monitor the situation, ensure that you have regular follow-ups with your healthcare provider to assess any changes in your condition.

In summary, while it’s understandable to feel apprehensive about seeking further medical advice, the persistence of your symptoms and the nature of the growths warrant a thorough evaluation. It’s always better to err on the side of caution when it comes to health concerns, especially those involving unexplained growths in the oral cavity. Your health and peace of mind are paramount, and ensuring that you receive appropriate care is essential.

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