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An unusual tonsillolith.
Bahar Sezer1, Zuhal Tugsel, Cem Bilgen
1Ege University, School of Dentistry, Department of Oral and Maxillofacial Surgery, Bornova 35100, Izmir, Turkey. baharsezer@yahoo.com
Summary
A large tonsillolith, a calcified deposit in the tonsil, was incidentally found during dental imaging. This benign finding can mimic serious jawbone lesions on panoramic radiographs.
Area of Science:
- Dentistry
- Oral Radiology
- Pathology
Background:
- Tonsilloliths are calcified masses in the palatine tonsils.
- Panoramic radiography is a common dental imaging technique.
- Soft tissue calcifications near the mandible can mimic intraosseous lesions.
Observation:
- A large left tonsillolith was incidentally detected during radiographic examination.
- The patient presented with unrelated right mandibular pericoronitis and had no tonsillar symptoms.
- The tonsillolith superimposed on the mandibular ramus, appearing as an intraosseous radiopaque lesion.
Findings:
- Tonsilloliths can be misinterpreted as various intraosseous mandibular pathologies on panoramic radiographs.
- Differential diagnosis is crucial for distinguishing tonsilloliths from true bone lesions.
- Common mimics include sialoliths, phleboliths, calcified lymph nodes, and arterial calcifications.
Implications:
- Awareness of tonsilloliths is essential for accurate radiographic interpretation in dentistry.
- Radiologists and dentists should consider soft tissue calcifications when evaluating mandibular radiopacities.
- Misdiagnosis can lead to unnecessary invasive investigations and patient anxiety.