Tonsillar neoplasm: experience of the 2nd Otorhinolaryngology Clinic from Cluj-Napoca
Authors:   Department of Head-Neck Surgery and Otorhinolaryngology, University Clinical Hospital of Railway Company, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania  Department of Anatomy and Embryology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania, Jeican Ionuț I. , Gheban Dan ,   Department of Pathology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania, Trombitas Veronica ,   Department of Head-Neck Surgery and Otorhinolaryngology, University Clinical Hospital of Railway Company, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania, Domşa Iacob ,   Department of Pathology, University Clinical Hospital of Railway Company, Cluj-Napoca, Romania, Fetica Bogdan ,   Department of Pathology, Ion Chiricuta Institute of Oncology, Cluj-Napoca, Romania, Crivii Carmen ,   Department of Anatomy and Embryology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania, Piciu Andra ,   Department of Medical Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania, Dumitru Mihai ,   Department of Head and Neck Surgery and Otorhinolaryngology, University Emergency Hospital, Bucharest, Romania  Department of Anatomy and Embryology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania, Aluaș Maria ,   Department of Oral Health, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania, Albu Silviu ,   Department of Head-Neck Surgery and Otorhinolaryngology, University Clinical Hospital of Railway Company, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
Published: April 2022

Introduction. The primary tonsillar neoplasm is a common malignancy of the head and neck, alcohol and/or cigarette smoke and Human Papilloma Virus is the main etiological agent. This study offers a retrospective analysis of the tonsillar neoplasm cases in a tertiary medical center from Romania. Patients and methods. We present a 4-year (2015-2018) retrospective study on 72 patients diagnosed with tonsillar neoplasm in our clinic, previously untreated patients. The study was included only the patients diagnosed through histopathological evaluation with tonsillar neoplasm. We searched the cases in our clinic database, and we collected data about age, gender, symptoms on admission, findings of the objective physical examination, oro-pharyngoscopy, medical imaging examination results, histopathological results, stage of the disease, therapeutic management. Results. The group composition is: 75% men and 25% women, 62.5% of them are smokers. Dysphagia/swallowing discomfort was the most common symptom identified, and the non-keratinized squamous cell carcinoma was the most common histopathological form. Stage I tonsil carcinoma was diagnosed in 25% of the cases, stage II in 15.3%, while 47.2% of the cases had stage III or IV. None of the patients presented distant metastases. Lymphoma was diagnosed in 12.5% of the cases. We performed for all patients in stages I and II underwent total unilateral tonsillectomy. For the patients in stages III and IV, we performed surgery after radiotherapy-chemotherapy treatment or only radiotherapy-chemotherapy. Conclusions. In Romania, smoking is still the most important risk factor for tonsil cancer. The majority of patients have visited a doctor only when dysphagia and, above all, palpable cervical adenopathy, were present, and the tumor was in the advanced stage. In Romania, the ENT-oncology integrated medical services are few, in most cases patients are lost from otorhinolaryngological follow-up.