0
Radiology Forum |

Quiz Case 2

Yuan-Ching Guo, MD; Pen-Yuan Chu, MD; Rheun-Chuan Lee, MD; Shyue-Yih Chang, MD
Arch Otolaryngol Head Neck Surg. 2001;127(1):84. doi:.
Text Size: A A A
Published online

Extract

A 77-YEAR-OLD man presented with a 2-year history of a foreign body sensation in the throat and an intermittent cough. He reported increasing dysphagia when swallowing solids but denied odynophagia, hoarseness, dyspnea, or any other medical problems. Initially, no laryngeal and hypopharyngeal abnormalities were detected by fiberoptic laryngoscopy (Figure 1A). During the examination, the patient started to cough, and a big polypoid mass (Figure 1B, arrow) suddenly appeared, seemingly from the postcricoid region. After the patient stopped coughing, the mass disappeared from our laryngoscopic view. Manual anterosuperior traction was then applied to the prelaryngeal skin to distend the hypopharynx. As the scope was advanced during this maneuver, 1 mass (Figure 1C, arrow) was found in the postcricoid region. The lesion appeared on the videoesophagogram (Figure 2) as a smooth or slightly lobulated intraluminal tumor (arrows) arising from the posterior aspect of the left side of the hypopharyngeal wall into the upper esophagus and connected by a long serpentine stalk (asterisks). It moved with deglutition and changed position during the video recording, as shown in Figure 2B-C. Figure 2A reveals the lesion's resting position before swallowing. Figure 2B shows an early pharyngeal phase, at which stage the lesion was pushed into the upper esophagus, and Figure 2C shows a late pharyngeal phase during swallowing, at which time the recoil of the long stalk could be seen. Computed tomographic scans of the neck revealed a soft tissue mass (Figure 3, asterisk) in the left aryepiglottic fold and postcricoid region. With the patient under general anesthesia, the lesion, which contained proteinaceous fluid, was removed via direct laryngoscopy and carbon dioxide laser. The histologic features are shown in Figure 4. One year after surgery, the patient was free of symptoms and remained healthy. Postoperative videoesophagography revealed normal performance of the pharynx and esophagus.

Figures in this Article

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

Correspondence

CME
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Topics
PubMed Articles
Jobs