Asymmetric tonsils or tonsillar cancer?

In the everyday practice of pediatrics, a finding of unilateral tonsillar enlargement (UTE) is common. Traditional clinical dogma has taught us that tonsillectomy for excisional biopsy to exclude cancer should be considered. Is that correct? Isn't most tonsillar asymmetry in children benign? Pediatric tonsillar cancer appears to be very rare.

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