Chronic throat pain

A woman aged 62 years presented with chronic throat pain on the right tonsillar area that had started approximately 2 years earlier. During the 2 years, she visited several local clinics, including internal medicine, family medicine and otolaryngology clinics, and underwent various tests, including esophagogastroduodenoscopy. However, there was no improvement in the symptom and the cause was not identified. She was referred by her family doctor to our hospital for further evaluation and proper management. The pain was characterised by an intermittent, needle-like, piercing pain on the right tonsillar area and could be worsened by swallowing and neck rotation. There was no history of any medical problems, trauma or surgery. Careful visual examination of the oral cavity and oropharynx revealed no particular abnormalities. During pharyngeal palpation, a hard mass was felt on the right tonsillar area and she complained of severe pain when turning her neck to the right.