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Clinical Problem Solving: Pathology
Aug 2011

Pathology Quiz Case 2

Author Affiliations
 

SECTION EDITOR: JULIA C. IEZZONI, MD

Arch Otolaryngol Head Neck Surg. 2011;137(8):830. doi:10.1001/archoto.2011.127-a

A 46-year-old man presented with a several-month history of dysphagia. He was otherwise healthy, denied tobacco or alcohol use, and reported a history of tonsillectomy. His voice was clear. Flexible laryngoscopy demonstrated a polypoid mass that filled the right piriform sinus and spilled into the laryngeal introitus (Figure 1). The vocal folds were mobile. A contrast computed tomogram of the neck showed a cystic-solid lesion in the region of the right piriform sinus, with an associated mass effect. The patient elected to undergo transoral laser excision of the hypopharyngeal mass. The resection was performed with suspension laryngoscopy and a handheld carbon dioxide laser (OmniGuide, Cambridge, Massachusetts). Multiple masses were resected, and it was confirmed that they emanated from the piriform sinus.

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