Giant tonsillolith

Tonsillar actinomycosis mimicking a tonsillolith: colonization of the palantine tonsil presenting as a foul‐smelling, removable, unilateral, giant tonsillar concretion

“…1,2 However, many authors still refer to this clinical situation as ''tonsillar actinomycosis''. [14][15][16] Similar to our patient's giant actinomyces ''sulfur'' granule, other children have also presented with foulsmelling, removable tonsillar actinomyces concretions. 3,6-11 Tonsillar actinomyces colonization has been observed in individuals ranging from infancy to adulthood 8,9,11,12 ; however, recent studies suggest that it may be more common in children over 5 years of age and adults.…”

“…They are composed of calcium salts-with or without other mineral salts-and are the result of a combination of the following: desquamative epithelium, serum, food debris, bacterial colonies and/or unresolved tonsillitis. [14][15][16] Similar to our patient's giant actinomyces ''sulfur'' granule, other children have also presented with foulsmelling, removable tonsillar actinomyces concretions. 13 Microscopic examination of the tonsillar concretion enables the diagnosis to be established.…”

“…[1][2][3][4][5][6][7][8][9][10][11][12][13] Tonsilloliths are calcifications that develop in tonsillar crypts. [14][15][16] A boy with recurrent halitosis-associated tonsillar actinomycosis, that presented as a removable giant unilateral tonsillar crypt concretion mimicking a tonsillolith, is described and the clinical characteristics, pathologic features, and management of actinomyces ''sulfur'' granules in tonsillar crypts are discussed.…”

Tonsillolithiasis and orofacial pain

“…On the other hand, in 9% of patients 2 , the tonsillolith was asymptomatic. Small concretions in the palatine tonsil are a common clinical finding in adults, although giant tonsillolith is a rare entity 3,25 and can also be mistaken for other anatomical and pathological structures of the pharyngeal region. Such mistakes are especially frequent when diagnosis is based upon a routine panoramic radiograph or lateral head radiograph.…”

“…Tonsilloliths are rare concretions that develop in enlarged tonsillar crypts 1 . Lang in 1560 first described oropharyngeal concretion, but the cause and pathogenesis still remain unknown 2,3 . Tonsilloliths occur more frequently in adults than in children 4 .…”