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|Year : 1980 | Volume
| Issue : 2 | Page : 147-8
Mankodi RC, Shah RM
|How to cite this article:|
Mankodi R C, Shah R M. Tonsillar pseudosarcoma. J Postgrad Med 1980;26:147
Pseudosarcoma has remained a controversial entity ever since its original description by Lane, in 1357. Its histogenesis and clinical behaviour has been much debated. This tumour has been commonly described in the region of oropharynx and larynx. We report here a case of tonsillar pseudosarcoma because of its rarity.
A 52 year old male patient was admitted to Dr. Balabhai Nanavati Hospital with complaints of pain in the throat of one month's duration. Pain was more during deglutition.
On local examination, left tonsil showed polypoidal enlargement. The right tonsil was normal. There was no lymphadenopathy. Systemic examination showed no abnormalities.
Investigations showed his haemoglobin to be 10.2 g. per cent. Total leukocyte count was 10,000/cu. mm. with P: 71, E: 3, L: 24, M: 2, His plain X-Ray of chest was normal. Clinical diagnosis of carcinoma tonsil was made. Tonsillectomy was carried out under general anaesthesia. Specimen was examined histopathologically.
The polypoidal growth measured 3 x 3 x 2 cms. It was soft and fleshy in appearance [Fig. 1]. Microscopically, it showed clusters of pleomorphic squamous cells infiltrating into the deeper tissue. Stroma was markedly cellular with many bizarre giant cells. Also seen were areas of necrosis and haemorrhage [Fig. 2].
Lane, in 1357 first reported eight cases of pseudosarcoma in pharynx and larynx. Later Goellner et al reviewed 25 cases at the Mayo clinic. On detail histochemical and electron microscopic study, he concluded that stromal changes are benign and reactive. Lichtiger et al were of the opinion that pseudosarcoma is essentially a spindle shaped variant of squamous cell carcinoma. Most of the workers believe that stromal changes are non-neoplastic; however, Minckler et al described a case with sarcomatous metastasis in the neck and hence he called it as carcino-sarcoma.
Pseudosarcoma is usually seen in the area of pharynx and larynx. The present case having pseudosarcoma in the tonsillar region is relatively rare. Clinically, the growth is usually polypoidal and behaves as squamous cell carcinoma.
In the present case no follow up was possible.
Authors are thankful to Dr. S. C. Sheth, Dean, Dr. Balabhai Nanavati Hospital for allowing us to publish this case report.
|1.||Friedel, W., Chamber, L. Q. and Atkins, J. P.: Pseudosarcomas of pharynx and larynx. Arch. Otolaryngol., 162: 286-290, 1976. |
|2.||Goellner, J. R., Devine, K. D. and Weiland, L. H.: Pseudosarcoma of the larynx. Amer. J. Clin. Path., 59: 312-326, 1573. |
|3.||Lane, N.: Pseudosarcoma associated with squamous cell carcinoma of the mouth, fauces and larynx. Cancer, 10: 1941, 1957. |
|4.||Lichtiger, B., Mackary, B. and Tessmer, C. F.: Spindle cell varient of squamous cell carcinoma. Cancer, 26: 1311-1320, 1970. |
|5.||Minckler, D. S., Meligro, C. H. and Norris, H. I.: Carcinosarcoma of larynx. Cancer, 26: 195-200, 1970. |