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Tonsilloliths, also known as tonsil stones or tonsillar calculi are clusters of calcified material that form in crypts of palatine tonsil. They are usually of small size. Large or giant tonsilloliths are rare. We report a case of giant tonsillolith in left palatine tonsil and literature is reviewed. Keywords: Tonsillolith, Tonsil stone.

Lymphoid papillary hyperplasia of the tonsils is a rare, benign lesion and is characterized by a papillomatous appearance with reactive follicular hyperplasia. Our case was unique because the lesion involved the unilateral and focal palatine tonsil, as the lesion usually involves the bilateral and entire palatine tonsils.

Hamartomas are disorganized but benign masses composed of cells indigenous to the involved site. They have been reported in almost all organs but are rare in the head and neck region, especially the pharynx. We describe the case of a six-month-old male infant who presented with acute respiratory symptoms due to a pedunculated polypoid mass arising from his left palatine tonsil. He underwent a tonsillectomy and removal of the polyp after initial stabilization. Histopathological examination showed features consistent with hamartoma. The child had an uneventful recovery and follow-up after one year showed no evidence of recurrence. Our case highlights that rare benign lesions like hamartoma originating in the oral cavity, even in infants, can have such an acute presentation and should be considered in differential diagnosis.

Myxofibrosarcoma is a soft tissue neoplasm, usually arising in elderly patients especially in the limbs, but very rarely in the head and neck region. We report a rare case of myxofibrosarcoma in the oropharynx. A 48-year-old man visited our department complaining of pharyngeal dysesthesia. A tumor was detected inside the left palatine tonsil. The cervical lymph node was not palpable. MRI showed a 40×25×20mm mass. Resection of the tumor was performed. The tumor was histopathologically and immunohistochemically diagnosed as low-grade myxofibrosarcoma. Myxofibrosarcoma is very rare in the oropharynx. Though the tumor is a low-grade malignancy, complete resection of the tumor must be performed.

Lipomas are benign tumors composed of mature fat cells. They occur frequently in subcutaneous tissue but rarely in the upper aerodigestive tract. Tonsillar lipomas are rare. To our knowledge, there are only six documented cases in the English literature. Here, we present the case of a 46-year-old Taiwanese female with a submerged oval yellowish mass in her left palatine tonsil. She received tonsillectomy and the pathologic diagnosis was tonsillar lipoma. The clinical presentation, management and literature review are also presented.

Meningiomas can occur at excranial and extraspinal sites such as the nose, nasopharynx and paranasal sinuses. Meningioma of the tonsil has seldom been described. We report a case of ectopic meningioma of the left palatine tonsil, in a 50-year-old male with no clinical or radiological evidence of an intracranial lesion. Follow-up at six months revealed no evidence of recurrence.

A polypoid, pedunculated tumour of the left palatine tonsil was incidentally detected in a 42-year-old female. It was composed of mature fat and was covered by a nonkeratinizing squamous epithelium with an underlying rim of fibrous tissue. The literature on tonsillar lipoma is reviewed and the differential diagnosis of polypoid lesions of the tonsil is discussed.

A 51-year-old man complained of foreign body feeling in the pharynx 2 months after surgery for lung cancer. The left palatine tonsil was coated with a dirty furlike covering. Biopsy revealed tonsillar metastasis from lung cancer (adeno carcinoma). Intravenous chemotherapy with a total dose of 40 mg of adriamycin and 200mg of cisplatinum reduced the size of the tonsillar tumor temporarily, but patient became cachectic and died after 6 months of treatment. The clinical findings in 10 cases of tonsillar metastasis reported in Japan are reviewed in this paper.