Cartilaginous Choristoma of the Palatine Tonsil: A Rare Histopathological Finding

Cartilaginous choristomas are rare benign lesions composed of mature hyaline cartilage at abnormal anatomical sites. While most commonly found in the tongue, involvement of the palatine tonsil is exceedingly uncommon and may mimic neoplastic or malignant lesions. We report the case of a 44-year-old female with recurrent tonsillitis who underwent right tonsillectomy. Histopathological examination revealed follicular hyperplasia with a well-circumscribed focus of mature hyaline cartilage within the tonsillar parenchyma, without atypia, establishing the diagnosis of cartilaginous choristoma. The exact pathogenesis remains uncertain, with proposed mechanisms including congenital developmental disturbances of the branchial arches, multi-lineage mesenchymal progenitor cell differentiation, or associations with mixed salivary gland tumors. Although most cases are asymptomatic and discovered incidentally, patients may present with throat discomfort, dysphagia, or foreign body sensation. Definitive management is surgical excision by tonsillectomy, with an excellent prognosis and no reported recurrences in tonsillar cases. This case highlights the importance of routine histopathological evaluation of tonsillectomy specimens to ensure accurate diagnosis and prevent unnecessary overtreatment.