Tonsil and Pharyngeal Wall Swelling: When to Seek Help

Tonsillar and posterior pharyngeal wall swelling?

Hello Dr.
Zheng, I consulted you two years ago regarding a lump on the right side of my neck, and you mentioned that no lump was found.
Earlier this year, I visited a clinic due to discomfort in my right neck and throat, where a laryngoscopy was performed, and the doctor diagnosed a cyst.
About two to three weeks ago, I experienced swelling and warmth on the right side of my neck, along with occasional mild stabbing pain in the right pharyngeal area.
I later noticed that my tonsils were enlarged, but there was little pain and no fever.
Subsequently, I experienced severe stabbing pain in my right ear for about two days (which eventually subsided), and I discovered a large red lesion on the right side of the posterior pharyngeal wall.
The information I found online is very limited, mostly suggesting that such symptoms could indicate tonsillar or pharyngeal cancer.
Is it possible that after the laryngoscopy earlier this year, which showed no issues, cancer could have developed since then? Due to work commitments, I won't be able to see you for another three weeks to a month.
Based on your expertise, do you think it is necessary for me to seek immediate medical attention? Thank you.

Li Yi, 20~29 year old female. Ask Date: 2023/10/27

Dr. Zheng Jueyi reply Otolaryngology

Hello, there are no obvious lumps found at this initial examination.
Common swelling and pain are often related to inflammation.
It is advisable to improve your daily routine, drink plenty of water, and reduce the intake of irritating foods.
If the symptoms persist without improvement, it is recommended to return for a follow-up visit at an ENT clinic or hospital for further evaluation.

Reply Date: 2023/10/27

More Info

When it comes to swelling in the tonsils and pharyngeal wall, it is essential to understand the potential causes and when to seek medical attention. Based on your description, there are several concerning symptoms that warrant a closer examination.

Firstly, the presence of a cyst in the neck, as noted in your previous examination, can sometimes be benign, but it can also become infected or inflamed, leading to swelling and discomfort. The recent development of swelling in your neck, along with the pain in your throat and ear, suggests that there may be an underlying issue that needs to be addressed. The fact that you have noticed a red area on the right side of your pharyngeal wall is particularly concerning, as this could indicate inflammation or infection.

While it is true that not all cases of tonsil or pharyngeal swelling are cancerous, the symptoms you describe—especially the sudden onset of pain and the visible changes in your throat—should not be ignored. The risk of malignancy, such as tonsillar or oropharyngeal cancer, increases with certain factors, including persistent symptoms, a history of smoking or alcohol use, and HPV infection. Although it is possible for a malignancy to develop relatively quickly, it is more common for such conditions to present with other symptoms over a longer period.

Given that you have experienced significant changes in your symptoms, including swelling, pain, and the appearance of a red lesion, it is advisable to seek medical attention sooner rather than later. While you mentioned that you may not be able to see your doctor for three weeks to a month, I would recommend that you try to schedule an earlier appointment if possible. If you experience worsening symptoms, such as increased pain, difficulty swallowing, or fever, you should seek immediate medical care.

In the meantime, it may be helpful to monitor your symptoms closely. Keep track of any changes in the size of the swelling, the intensity of the pain, and any new symptoms that may arise. This information will be valuable for your healthcare provider when you are able to see them.

In summary, while not all cases of tonsil and pharyngeal swelling are indicative of cancer, the combination of your symptoms suggests that further evaluation is necessary. It is better to err on the side of caution and seek medical advice sooner rather than later, especially given the potential for complications associated with infections or malignancies in the throat area. Your health and peace of mind are paramount, and timely intervention can lead to better outcomes.

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