Key words : dysphagia; tonsil stone
Key Clinical Message: Small tonsilloliths are usually
asymptomatic, whereas large tonsilloliths are sometimes associated with
recurrent sore throat and odynophagia.
A 68-year-old woman developed sudden right-sided sore throat and
odynophagia, 3 weeks after she presented to our hospital. She visited an
otolaryngologist and underwent fiberoptic laryngoscopy, which did not
reveal any abnormalities, including a foreign body. She denied any past
medical history, was concerned about her halitosis or bad breath.
Physical examination revealed no tonsillar abnormalities. Detailed
evaluation showed a firm, nodular mass in the tonsillar crypts.
Laboratory data showed normal serum calcium levels. Computed tomography
revealed a dense calcified mass in the right palatine tonsil (Figure 1).
The mass was excised under local anesthesia; it measured 6 mm × 4 mm in
size and appeared hard, with an irregular surface (Figure 2) and was
diagnosed as a tonsillolith. The patient showed no recurrence of the
tonsillolith at 3-month follow-up.
Tonsilloliths are products of calcified accumulates of food, cellular
debris, and microorganism aggregates in the crypts of palatine
tonsils.1 Small tonsilloliths are usually
asymptomatic, whereas large tonsilloliths are sometimes associated with
recurrent sore throat and odynophagia.1,2