Tonsillar lymphangioma with adipose and smooth muscle proliferation: a case report.

BACKGROUND

Lymphangiomatous lesions commonly occur in the head and neck region; however, involvement of the palatine tonsil is rare. Tonsillar lymphangiomatous polyps containing both adipose tissue and smooth muscle proliferation are exceptionally uncommon. We report a rare case of tonsillar lymphangioma with adipose tissue and focal smooth muscle proliferation.

CASE PRESENTATION: A 28-year-old Iranian man presented with sore throat and was found to have a pedunculated mass arising from the right palatine tonsil. Physical examination revealed a smooth-surfaced, non-ulcerated polypoid lesion measuring 2 × 1 × 0.3 cm. Owing to the small size and clinically benign appearance of the lesion, no preoperative imaging was performed. Right-sided tonsillectomy was undertaken. Histopathologic examination demonstrated a lymphangiomatous polyp (lymphangioma) composed of dilated lymphatic channels within a fibroadipose stroma with focal smooth muscle proliferation. The lesion was completely excised with negative surgical margins. No recurrence was observed during 1 year of follow-up.

CONCLUSIONS

Tonsillar lymphangiomatous lesions are rare benign entities that may clinically mimic other tonsillar masses. Histopathologic examination is essential for definitive diagnosis. Complete surgical excision appears curative, and recurrence is uncommon.