CASE HISTORY – June 2009

Tonsillolith. A case report and a literature overview


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We present the case of a 31-year-old woman with a 6-month history of left-side dysphagia, odynophagia, foreign body sensation and  halitosis. On exploration the oropharynx appeared normal at fi rst sight: no swelling, no hyperemia in the region of the tonsils.  However, palpation of the left tonsil area revealed resistance felt in the upper pole of the left tonsil, which was painful for the patient. CT revealed a delimited and highly calcified oval image measuring 1.2 x 0.5 x 1.5 cm, which was surgically removed. Tonsilloliths or tonsillar concretions are not a very common pathology. These  concretions are composed of carbonates or phosphates of calcium salts either alone or in combination with other minerals. Tonsilloliths are most commonly found in the tonsillar tissue. They may be asymptomatic, discovered accidentally, but they can also be symptomatic, sometimes mimic an abscess or even neoplasia.