Unraveling Fibrous Tonsil Lesions: A Case Series on Diagnostic Dilemmas in Pediatric Tonsillectomy.

PURPOSE: This study examines the challenges associated with diagnosing and managing fibrous tonsillar lesions in pediatric patients undergoing tonsillectomy and adenoidectomy. In this report, we outline our strategy for navigating these patients' clinical presentation while maintaining a broad differential diagnosis in pediatric tonsil lesions.

METHODS

This retrospective case series analyzes two pediatric patients who underwent tonsillectomy and adenoidectomy for symptoms related to sleep-disordered breathing and obstructive sleep apnea.

RESULTS

Both cases displayed substantial tonsillar hypertrophy with fibrous, polyploid lesions. Subsequent histopathological analysis revealed fibroepithelial polyps (FEPs) in one case, while the other demonstrated tonsillar hyperplasia. Following surgery, recovery for both cases was largely unremarkable, with one patient developing a transient fever and the other managing mild postoperative pain with analgesics.

CONCLUSIONS

These cases illustrate the diagnostic complexity of pediatric tonsillar pathology and emphasize the need to maintain a broad differential diagnosis for tonsillar lesions. Thorough histopathological evaluation and transparent communication with patients and their families are essential for enhancing patient-centered care.