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Clinical Challenge | Radiology

A Recurrent, Slow-Growing Retropharyngeal Lesion QUIZ

Jessica R. Winters, MD1; Bennett L. Davis, MD2; Jonathan M. Melzer, MD1
[+] Author Affiliations
1Department of Otolaryngology–Head and Neck Surgery, Naval Medical Center Portsmouth, Portsmouth, Virginia
2Department of Radiology, Naval Medical Center Portsmouth, Portsmouth, Virginia
JAMA Otolaryngol Head Neck Surg. 2016;142(6):599-600. doi:10.1001/jamaoto.2016.0265.
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A woman with a history of a benign retropharyngeal mass reported return of her symptoms, including mouth breathing, snoring, nasal obstruction, Eustachian tube dysfunction, and transient upper extremity paraplegias; MRI revealed a complete recurrence and enlargement of the mass. What is your diagnosis?

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A, T1-weighted magnetic resonance imaging (MRI). Arrowhead indicates the oropharynx. B, T2-weighted MRI. Arrowhead indicates soft tissues; asterisk, thecal sac. C, Fat-saturated T1-weighted postcontrast MRI. D, Computed tomographic image (CT), bone windows. Arrowhead indicates the anteromedial aspect of the left foramen transversarium of C1.

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