A large tonsillolith in a 48-year-old woman is reported. The patient had complained of pharyngeal discomfort for three years. X-ray examination revealed a large calcification at the left supratonsillar fossa. CT revealed a high-density mass and MRI revealed a low density area in the same place. Tonsillectomy of the l e ft side was performed under general anesthesia. The stone was 20 X 16 mm and contained CaPO4 75% and CaCO3 25%. To date,18 cases of tonsillolith have been reported in Japan. The literature on tonsillolith is reviewed.
