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Clinical Problem Solving: Radiology |

Radiology Quiz Case 2

Wojciech K. Mydlarz, BS; Murugappan Ramanathan Jr, MD; Nafi Aygun, MD; Ralph P. Tufano, MD
Arch Otolaryngol Head Neck Surg. 2007;133(7):725. doi:10.1001/archotol.133.7.725.
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An otherwise healthy 63-year-old man presented with a 6-month history of progressive dysphagia to solid and liquid food. He was initially evaluated by a gastroenterologist, and upper gastrointestinal endoscopy revealed an obstructive hypopharyngeal mass. The patient was referred to an otolaryngologist for further workup, but because of a delay in follow-up, he developed severe dyspnea, requiring emergent intubation and placement of a tracheostomy tube. He was a nonsmoker and his medical history was unremarkable. Physical examination revealed that there were no neck masses or lymphadenopathy. Inspection of the oral cavity and oropharynx disclosed no abnormalities. Flexible fiberoptic laryngoscopic examination was remarkable only for a large, lobulated mass emanating from the hypopharynx and the postcricoid region. The mass extended superiorly, obstructing the view of the true vocal folds, and abutted the epiglottis.

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