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An otherwise healthy, heavy smoker 55-old man was admitted to the ENT Clinic of Emergency County Hospital of Tg. Mures¸ (Romania) with an one-two months history of progressively enlarging, painless left tonsil associated with odynophagia, repeated bleeding and hemoptysis. Intraoral local examination revealed swelling of left tonsil with smooth surface, elastic consistency, covered by ulcerated epithelium. The right tonsil, head, ears, and nose had no remarkable modifications. Physical examination revealed no palpable lymphadenopathy or organomegaly.The patient did not mentioned any history of weight loss and excessive sweating. Routine laboratory investigation results were within the reference ranges. CT scan confirmed the enlargement of the left tonsil, but inadherent to adjacent structures, without other tumor mass in the head-neck region and thorax. Based on the general systemic examination and lack of inflammatory markers elevation, the clinical diagnosis of a tonsillar malignant tumor was estimated. The patient underwent bilateral classical tonsillectomy under general anesthesia, both tonsils were sent for histopathology (Department of Pathology, UMF). Macroscopic examination showed preserved morphological structure of the resected right tonsil. The left tonsil was covered with partially ulcerated epithelium, on the cut surface, and centrally presented a 16 mm, relatively well-circumscribed, white-yellow soft tumor mass impregnated with multiple haemorrhagic foci. Details of microscopic findings (routine HE staining): Fig. 1 left tonsill, Fig. 2-4 tumor tissue.


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