Clinical Problem Solving: Radiology |

Radiology Quiz Case 1

Christian Koehler, MD; Monika Warmuth-Metz, MD; Robert Mlynski, MD
Arch Otolaryngol Head Neck Surg. 2010;136(5):518. doi:10.1001/archoto.2010.60-a.
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An 80-year-old man presented with a lesion that had been observed on magnetic resonance images (MRIs) of his head and neck. The MRIs had been obtained because of reduced motility of the patient's left eye and left facial weakness. Six months earlier, he had developed otitis externa maligna with a partial facial nerve palsy and had undergone a mastoidectomy with a radical cavity on the left. Physical examination revealed a unilateral bulge of the left soft palatine arch that was obstructing the nasopharynx and the oropharynx. The mass was not pulsatile, and fluid could not be aspirated on puncture. Also, there was paralysis of the left abducens nerve and the left vocal fold. Ear microscopy showed an unirritated radical cavity. The patient appeared somnolent and disoriented, without signs of pain.

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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.
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