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Hamartomatous Polyp of the Palatine Tonsil: A Case Report and Critical Literature Review

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Abstract

Background

Hamartomatous polyp of the palatine tonsil is a rare benign tumor poorly recognized by clinicians and pathologists. We present a novel case report and provide a literature review about this diagnosis, highlighting its clinicopathological features and treatment modalities.

Methods

We herein report a case of a 22-year-old female patient who complained of a foreign body sensation in her throat. She presented with a pedunculated polyp attached to her right palatine tonsil, which was noticed 15 years ago. An excisional biopsy was performed under local anesthesia, and the microscopic aspect confirmed the diagnosis of the hamartomatous polyp of the palatine tonsil. The literature review was performed using the “palatine tonsil polyps” term in PubMed and Google Scholar. Only English-language publications showing clinical and microscopic descriptions were selected as inclusion criteria.

Results

As in our case report, this poorly understood lesion usually presents as a solitary, unilateral pedunculated mass attached to the palatine tonsil surface with nonspecific symptoms. The literature shows less than 100 cases reported, which reveals a lesion preference for male and young adult patients. Microscopically, it is characterized by disorganized proliferation of the connective tissue components indigenous to the involved site, with variable lymphangiectasia, which accounts for the diversity of the diagnostic term and its unknown incidence. Its treatment consists of excision of the polyp with or without tonsillectomy, and no recurrence or malignant transformation of these polyps has been reported.

Conclusion

The hamartomatous polyp of the palatine tonsil is challenging due to its rarity and lack of standardization of the terminology used in the literature. Including this diagnosis in the 5th edition of the World Health Organization Classification for Head and Neck Tumors is expected to contribute to a better understanding of this pathology.

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References

  1. Arambula A, Brown JR, Neff L (2021) Anatomy and physiology of the palatine tonsils, adenoids, and lingual tonsils. World J Otorhinolaryngol - head neck surg, Elsevier Ltd, pp 155–160 (7)

    Google Scholar 

  2. Meegalla N, Downs BW, Anatomy, (2022) Head and Neck, Palatine Tonsil (Faucial Tonsils). StatPearls, Florida

    Google Scholar 

  3. Sethi A, Sethi D, Bansal R (2011) True hamartoma of the tonsil. Indian J Otolaryngol Head Neck Surg 63:99–101

    Article  PubMed  PubMed Central  Google Scholar 

  4. Badoual C (2022) Update from the 5th Edition of the World Health Organization classification of Head and Neck Tumors: Oropharynx and Nasopharynx. Head Neck Pathol Springer US 16:19–30

    Article  Google Scholar 

  5. Shara KA, Al-Muhana AA, Al-Shennawy M (1991) Hamartomatous tonsillar polyp. J Laryngol Otol 105:1089–1090

    Article  CAS  PubMed  Google Scholar 

  6. Lupovitch A, Salama D, Batmanghelichi O (1993) Benign hamartomatous polyp of the palatine tonsil. J Laryngol Otol 107:1073–1075

    Article  CAS  PubMed  Google Scholar 

  7. Duggal P, Chakravorty S, Sharma S, Ahluwalia RK (2008) Pedunculated hamartomatous polyp of palatine tonsil in a child: a new presentation. Int J Pediatr Otorhinolaryngol Extra 3:120–123

    Article  Google Scholar 

  8. Singh M, Mundi DK, Kaur I, Kaur A (2017) Hamartomatous polyp of the tonsil: a case report. Niger J Clin Pract 20:774–776

    Article  CAS  PubMed  Google Scholar 

  9. Farboud A, Trinidade A, Harris M, Pfleiderer A (2010) Fibroepithelial polyp of the tonsil: case report of a rare, benign tonsillar lesion. J Laryngol Otol 124:111–112

    Article  CAS  PubMed  Google Scholar 

  10. Telugu RB, Ashish G (2015) Fibroepithelial polyp of the Tonsil: report of a rare case. J Clin Diagn Res 9:ED17–ED18

    PubMed  PubMed Central  Google Scholar 

  11. Kipuzha R, Polimoottil D, Bakkshi S, Gopalakrishnan S (2018) Fibroepithelial polyps of the Head and Neck. J Dent Allied Sci 7:88–90

    Google Scholar 

  12. Cukic O, Jovanovic MB (2020) Large fibroepithelial polyp of the Palatine Tonsil. Ear Nose Throat J 99:247–248

    Article  PubMed  Google Scholar 

  13. Marini K, Garefis K, Skliris JP, Peltekis G, Astreinidou A, Florou V (2021) Fibroepithelial polyp of palatine tonsil: a case report. Pan Afr Med J 39:276

    Article  PubMed  PubMed Central  Google Scholar 

  14. Borges A, Bikhazi H, Wensel JP (1999) Giant fibrovascular polyp of the oropharynx. AJNR Am J Neuroradiol 20:1979–1982

    CAS  PubMed  PubMed Central  Google Scholar 

  15. Aslıer NGY, Aslıer M (2017) Unilateral Pedunculated Lymphangiectatic Fibrolipomatous Polyp of the Palatine Tonsil: a rare case. Turkish Arch Otorhinolaryngol 55:91–94

    Article  Google Scholar 

  16. Hiraide F, Inouye T, Tanaka E (1985) Lymphangiectatic fibrous polyp of the palatine tonsil. A report of three cases. J Laryngol Otol 99:403–409

    Article  CAS  PubMed  Google Scholar 

  17. Iliadou E, Papapetropoulos N, Karamatzanis E, Saravakos P, Saravakos K (2016) Primary lymphangioma of the Palatine Tonsil in a 9-Year-old boy: a Case Presentation and Literature Review, vol 2016. Case Rep Otolaryngol. Hindawi Publishing Corporation, p 1505202

  18. Mehta S, Jha S, Adhya AK, Mitra S (2019) Lymphangiofibrolipomatous hamartomaous polyp of tonsil. BMJ Case Rep 12:9–10

    Article  Google Scholar 

  19. Kardon DE, Wenig BM, Heffner DK, Thompson LDR (2000) Tonsillar Lymphangiomatous polyps: a clinicopathologic series of 26 cases. Mod Pathol 13:1128–1133

    Article  CAS  PubMed  Google Scholar 

  20. Roth M (1996) Lymphangiomatous Polyp of the Palatine Tonsil. Otolaryngol Neck Surg 115:172–173

    Article  CAS  Google Scholar 

  21. Shetty SC, Balasubramanya AM, Chary G, Amirtham U, Garg I (2000) Tonsillar lymphangiomatous polyp — a case report. Indian J Otolaryngol Head Neck Surg 52:283–284

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Ryu HS, Jung SY, Koh J-S, Lee S-S (2006) Tonsillar lymphangiomatous polyp: report of two cases. Korean J Pathol 40:381–384

    Google Scholar 

  23. Chen HH, Lovell MA, Chan KH (2010) Bilateral lymphangiomatous polyps of the palatine tonsils. Int J Pediatr Otorhinolaryngol 74:87–88

    Article  PubMed  Google Scholar 

  24. Park E, Pransky SM, Malicki DM, Hong P (2011) Unilateral lymphangiomatous polyp of the palatine tonsil in a very young child: a clinicopathologic case report. Case Rep Pediatr 2011:451542

    PubMed  Google Scholar 

  25. Cengiz BP, Acar M, Giritli E (2013) A pedunculated lymphangiomatous polyp of the palatine tonsil: a case report. Braz J Otorhinolaryngol 79:402

    Article  PubMed  Google Scholar 

  26. Gunbey E, Günbey HP, Dölek Y, Karabulut YY (2014) A rare cause of dysphagia in children: lymphangiomatous polyp of the palatine tonsil. J Craniofac Surg 25:e346–e348

    Article  PubMed  Google Scholar 

  27. Kim KS (2015) Review of Lymphangiomatous Polyp of the Palatine Tonsil. J Craniofac Surg 26:e369–e370

    Article  PubMed  Google Scholar 

  28. Khatib Y, Gite V, Patel R, Shoeb M, Oraon A (2015) Lymphangiomatous Polyp of Palatine Tonsil in a child presenting with Dysphagia and Dysarthria. J Clin Diagn Res 9:ED01–2

    PubMed  PubMed Central  Google Scholar 

  29. Hay C, Kozielski R, Behar P (2017) A Young Man with enlarging unilateral Tonsil Mass. JAMA Otolaryngol Neck Surg 143:309

    Article  Google Scholar 

  30. Chye Gan B, Nor Najmiyah Wan Abdul, Wahab W, Tuan Sharif SE, Mat Lazim N, Mohamad I (2017) Bilateral tonsillar lymphangiomatous polyps in a snoring child. Pediatr i Med Rodz 13:419–422

    Article  Google Scholar 

  31. Dhakal A, Karmacharya S, Shrestha S (2017) Lymphangiomatous Polyp presenting as Tonsillar Mass. Case Rep Otolaryngol Hindawi 2017:9506260

    Google Scholar 

  32. Gan W, Xiang Y, He X, Feng Y, Yang H, Liu H et al (2019) A CARE-compliant article: lymphangiomatous polyps of the palatine tonsils in a miner: a case report. Med (Baltim) 98:e14009

    Article  Google Scholar 

  33. Rajan GS, Kannan DS, Narendrakmar V, Baby AN (2020) Large lymphangiomatous polyp present in palatine tonsil: a case report. Int J Otorhinolaryngol Head Neck Surg 6:1351

    Article  Google Scholar 

  34. Min HJ, Kim KS (2021) Lymphangiomatous Polyp Arising From the Palatine Tonsil. Ear, Nose Throat J. 100:NP154–NP155

    Article  PubMed  Google Scholar 

  35. Barreto I, Juliano P, Chagas C, Altemani A (2007) Lymphoid polyps of the palatine tonsil. Int J Surg Pathol 15:155–159

    Article  PubMed  Google Scholar 

  36. Ji H, Ulualp SO, Sengupta A (2017) A rare cause of tonsil mass in a child: lymphoid polyp. SAGE open Med case reports 5:2050313X16688832

    Article  Google Scholar 

  37. Al Samarrae SM, Amr SS, Hyams VJ (1985) Polypoid lymphangioma of the tonsil: report of two cases and review of the literature. J Laryngol Otol 99:819–823

    Article  CAS  PubMed  Google Scholar 

  38. Mardekian S, Karp JK (2013) Lymphangioma of the palatine tonsil. Arch Pathol Lab Med 137:1837–1842

    Article  PubMed  Google Scholar 

  39. Balatsouras DG, Fassolis A, Koukoutsis G, Ganelis P, Kaberos A (2011) Primary lymphangioma of the tonsil: a case report. Case Rep Med 2011:183182

    Article  PubMed  PubMed Central  Google Scholar 

  40. Barreto I, Costa AF, Martins MT, Furuse C, de Araújo VC, Altemani A (2011) Immunohistochemical study of stromal and vascular components of tonsillar polyps: high endothelial venules as participants of the polyp’s lymphoid tissue. Virchows Arch 459:65–71

    Article  CAS  PubMed  Google Scholar 

  41. Santana-Hernandez DJ, Ell SR, Da Costa P, Macklin CP, Hussain SS (1996) Giant hamartoma of the oropharynx. J Laryngol Otol 110:480–482

    Article  CAS  PubMed  Google Scholar 

  42. Ebenezer JA, Mathews SS (2022) Hairy polyp of the Nasopharynx Associated with hypoplastic soft palate, low eustachian tube orifice, and Tonsil. Ear Nose Throat J 101:NP68–70

    Article  PubMed  Google Scholar 

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Funding

This study was not supported by any funding.

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Authors and Affiliations

  1. Faculty of Dentistry, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, 79070-900, Brazil

    Gleyson Kleber do Amaral-Silva, Jhennyfer Ribeiro-Brizola, Áthilla Arcari Santos, Silvia Roberta Cieslak-Sanches, Gabriela Moura Chicrala, Ellen Cristina Gaetti-Jardim & Daniella Moraes Antunes

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  1. Gleyson Kleber do Amaral-Silva
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  2. Jhennyfer Ribeiro-Brizola
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  3. Áthilla Arcari Santos
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  6. Ellen Cristina Gaetti-Jardim
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  7. Daniella Moraes Antunes
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Contributions

Gleyson Kleber do Amaral-Silva and Jhennyfer Ribeiro-Brizola contributed to conceptualization. Ellen Cristina Gaetti-Jardim and Daniella Moraes Antunes contributed to supervision. Áthilla Arcari Santos, Silvia Roberta Cieslak-Sanches, and Gabriela Moura Chicrala contributed to visualization. Jhennyfer Ribeiro-Brizola contributed to writing—original draft. Gleyson Kleber do Amaral-Silva and Daniella Moraes Antunes contributed to writing—review & editing.

Corresponding author

Correspondence to Gleyson Kleber do Amaral-Silva.

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The study was performed following the 1964 Helsinki Declaration standards.

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do Amaral-Silva, G.K., Ribeiro-Brizola, J., Santos, Á.A. et al. Hamartomatous Polyp of the Palatine Tonsil: A Case Report and Critical Literature Review. Head and Neck Pathol 17, 502–508 (2023). https://doi.org/10.1007/s12105-023-01529-x

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