PE: WNHM PRESENTS TO ED C/O COUGH W/ BLOOD TINGED MUCUS, NOSEBLEED. SOFT TISSUE SWELLING IN RT THROAT W/ VOICE CHANGE. PE BY DR. B: RT TONSIL MASS IS GROSSLY VISIBLE. PALPABLE ABN IN RT NECK CORRESPONDING TO TONSIL MASS 1/2 - 1 CM. NO PALPABLE LYMPHADENOPATHY IN CERVICAL OR SUPRACLAVICULAR REGION. NEVER SMOKER. SOCIAL ETOH USE. NO FHX OF CA. ****** 8/1/18 IMAGING: CT NECK: ENLARGEMENT OF THE RT PALATINE TONSIL. 8/10/18 PET: NECK HYPERMET FOCUS W/ SOFT TISSUE THICKENING THE RT TONSILLAR REGION SUSPICIOUS FOR NEOPLASTIC PROCESS. MILDLY HYPERMET RT CERVICAL LN. NO EVIDENCE OF DISTANT METS IN THE SCAN. ****** PATHOLOGY: 8/8/18 RT TONSIL LESION BX - INV MOD DIFF PREDOMINANTLY KERATINIZING SQUAMOUS CELL CA. 9/5/18 RT RADICAL TONSILLECTOMY - 4.0 CM INV POORLY DIFF SQUAMOUS CELL CA, HPV NEGATIVE. TUMOR IS UNIFOCAL, LOCATED IN OROPHARYNX, PALATINE TONSIL. RT LEVEL 2 AND 2B LYMPH NODE EXCISION - NEG (0/3). RT LEVEL 3 EXC - NEG (0/4). RT LEVEL 4 EXC - NEG (0/5). NO LVI, NO PNI. ****** LABS: p16 NEG. ****** OPERATIONS: 8/8/18 RT TONSIL MASS BX 9/5/18 RT RADICAL TONSILLECTOMY RT MODIFIED RADICAL NECK DISSECTION. ******