About 90% of tonsillar cancers are squamous cell carcinomas. These tumors are relatively frequent, occurring mostly between the ages of 50 and 70. They are three to four times more common in males than females and are often associated with a history of smoking and drinking alcohol. Sixty percent of patients present with cervical metastases that is bilateral in 15% of the cases. Distant metastases are found in about 7%. SEE PICTURES OF TONSIL CANCER WITH METASTASIS
This left tonsillar squamous cell carcinoma exhibits enlargement and ulceration of the tonsil. Squamous cell carcinomas of the tonsils are not necessarily exophytic or ulcerated. They may look identical in appearance to lymphomas and can only be distinguished by histologic examination.
LYMPHOMA OF THE TONSIL
Lymphoma is the second most common type of tonsillar malignancy. Lymphoma of the tonsil usually presents with a submucosal mass in an asymmetrical enlargement of one tonsil. When lymphadenopathy is present, multiple enlarged lymph nodes commonly are observed on the same side of the neck.
Lymphomas are difficult to distinguish from undifferentiated carcinomas and lymphoma markers are required to establish the diagnosis. Such studies require a large amount of tissue which is sent fresh (in saline, not formaldehyde) to the pathologist. This is why a tonsillectomy is preferable to a biopsy.