How to Tell the Difference Between Tonsil Cysts and Tonsil Cancer

Tonsillar cysts and tonsil cancer can produce overlapping symptoms. A clinician can distinguish between them using tests such as imaging and tissue sampling.

Your tonsils are collections of lymphatic tissue located at the back of the throat. They play a role in defending your body from pathogens entering through the mouth.

Cysts are benign, fluid-containing growths that can form on the tonsils. They frequently remain symptom-free until they become sizable.

Tonsil cancer is a common form of oral and oropharyngeal cancer. The predominant variety is squamous cell carcinoma.

Tonsil cyst vs. cancer symptoms

A tonsil cyst typically appears as a painless lump.

A physician may notice it during a routine check, though some people report difficulty swallowing or a sensation of something lodged in the throat.

Less frequently, symptoms can include:

• dry cough
• ear discomfort
• throat soreness

Possible symptoms of tonsil cancer include:

• one tonsil appearing larger than the other
• painless lump in the neck
• persistent sore throat
• ear pain
• swallowing difficulties
• halitosis (bad breath)
• sensation of a foreign body in the throat
• tonsillar bleeding
• enlarged lymph nodes

Photos of tonsil cysts and tonsil cancer

Below is an example showing how a tonsil cyst and tonsil cancer may appear.

What causes tonsil cysts and tonsil cancer?

Tonsil cancer arises from genetic alterations in tonsillar cells. Tonsil cysts can stem from various origins.

Tonsil cysts

According to a 2019 review, the most frequent cyst type on the tonsils is the tonsillar retention cyst. These form when a mucus gland becomes obstructed.

Less common tonsillar cyst types include:

• Mucocele cysts: These often develop after trauma and are caused by saliva accumulation that produces swelling.
• Dermoid cysts: Dermoid cysts arise from entrapped cells and can occur in many body sites.
• Lymphoepithelial cysts: These may form when openings in the tonsils become obstructed by accumulated cells. They are extremely rare on the tonsils, with only about six reported cases in that location in the medical literature.
• Epidermoid cysts: The same 2019 paper notes that fewer than 1 in 1,000 oral epidermoid cysts occur on the tonsils. They develop when surface cells become buried beneath new cells instead of shedding.

A peritonsillar abscess can mimic a cyst. It’s a bacterial collection that usually follows untreated strep throat, resulting in a pus-filled swelling on or near a tonsil at the back of the mouth’s roof.

A peritonsillar abscess is commonly associated with significant pain and fever.

Tonsil cancer

As with other cancers, tonsil cancer is caused by genetic changes that drive uncontrolled cell growth. These alterations may be inherited or arise from damage accumulated over time.

Who gets tonsil cysts and tonsil cancer?

Oral cysts frequently appear without a clear trigger or identifiable risk factors. Oral lymphoepithelial cysts occur at similar rates in men and women and typically present around 44 years of age.

Risk factors for tonsil cancer include:

• tobacco use
• excessive alcohol consumption
• HPV infection
• family history of oral cancer

When to contact a doctor

You should see a clinician if you notice changes to your tonsils, such as swelling at the back of the throat or ongoing throat pain that persists beyond roughly 2 weeks.

Throat discomfort can result from many causes, and some of them need medical evaluation.

Diagnosing tonsil cysts vs. cancer

Many tonsillar cysts are too small to cause obvious symptoms. A clinician may identify them during an exam or via imaging studies such as CT or MRI scans.

If cancer is suspected, a doctor may request a biopsy. A biopsy removes a small tissue sample for laboratory analysis by a specialist.

How do doctors treat tonsil cysts and tonsil cancer?

Small, asymptomatic cysts often require no treatment. However, surgeons can excise larger cysts to relieve symptoms.

Common treatment options for tonsil cancer include:

• surgical removal
• radiation therapy
• combined chemotherapy and radiation

Can you prevent tonsil cysts or tonsil cancer?

Tonsil cysts generally develop without an obvious cause and are not typically preventable.

You may lower your risk of tonsil cancer by:

• avoiding tobacco
• limiting alcohol intake
• receiving the HPV vaccine

Frequently asked questions about tonsil cysts vs. tonsil cancer

Below are common questions people ask about tonsillar cysts and tonsil cancer.

How serious is a tonsil cyst?

Tonsillar cysts are generally benign. Nonetheless, it’s important to consult a healthcare professional if you suspect one, as occasionally they can indicate a more serious condition.

What do tonsil cancer lesions look like?

Tonsil cancer can make one side of the throat appear different from the other, with possible swelling or red and white areas.

How do I know if my tonsil cyst is cancerous?

A medical evaluation is required to determine whether a cyst is malignant. A clinician can arrange imaging or a biopsy to confirm or exclude cancer.

Takeaway

Tonsillar cysts are often small and may not produce noticeable symptoms. Tonsil cancer more commonly causes a persistent sore throat or a distinct lump on one side of the throat.

If you have throat symptoms lasting longer than about 2 weeks, see a doctor. Many conditions can cause throat problems, and some need treatment.