case_images: PMC11786789_01
case_images: Clinical photograph taken pre-operatively showing left-side grade 4 and right-side grade 3 tonsil with irregular surface obstructing oropharynx
case_images: cureus-0017-00000076797-i01.jpg
case_images: PMC11786789_01_cureus-0017-00000076797-i01.jpg
case_images: FIG1
case_images: Oral examination revealed left grade 4 tonsil and right grade 3 tonsil, obstructing the oropharynx (Figure 1).
case_images: Coronal section of contrast-enhanced CT scan showing bilaterally enlarged tonsils with heterogeneous post-contrast enhancement and foci of peripheral calcification
case_images: cureus-0017-00000076797-i02.jpg
case_images: PMC11786789_01_cureus-0017-00000076797-i02.jpg
case_images: FIG2
case_images: The patient was advised to undergo a contrast-enhanced CT scan of the neck, which was suggestive of soft tissue density areas present in the bilateral tonsillar region, approximately 23 x 23 mm on the right side and 22 x 31 mm on the left side, with heterogeneous post-contrast enhancement and foci of peripheral calcification (Figure 2).
case_images: Postoperative specimen of bilateral tonsils showing whitish-brown areas with cysts
case_images: cureus-0017-00000076797-i03.jpg
case_images: PMC11786789_01_cureus-0017-00000076797-i03.jpg
case_images: FIG3
case_images: Upon sectioning, whitish-brown areas were noted along with multiple cysts (Figure 3).
case_images: (H & E stain, 10x) Section shows para keratinized stratified squamous epithelium encasing lymphoid follicle of variable size and shape. Two cysts lined by benign stratified squamous epithelium containing loose keratin material also seen
case_images: cureus-0017-00000076797-i04.jpg
case_images: PMC11786789_01_cureus-0017-00000076797-i04.jpg
case_images: FIG4
case_images: No evidence of granuloma or malignancy was found (Figure 4).
case_images: Postoperative clinical photograph taken after six months of surgery
case_images: cureus-0017-00000076797-i05.jpg
case_images: PMC11786789_01_cureus-0017-00000076797-i05.jpg
case_images: FIG5
case_images: There were no significant side effects or recurrences at the six-month follow-up, as shown in Figure 5.