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Clinical Problem Solving
February 2014

A Retropharyngeal Mass in a Young Boy

Author Affiliations
  • 1University of Missouri School of Medicine, Columbia
JAMA Otolaryngol Head Neck Surg. 2014;140(2):173-174. doi:10.1001/jamaoto.2013.6068

A young boy was noted during routine adenotonsillectomy to have a large firm mass in the posteriolateral pharyngeal wall and was referred to a tertiary medical center. Postoperatively, he developed mild velopharyngeal insufficiency. On flexible endoscopy, the posterior pharyngeal mass was clearly visible. Magnetic resonance imaging (MRI) of the neck revealed a 3 × 2 × 1-cm fusiform lesion attached to the medial aspect of the left carotid space, extending to the midline retropharyngeal space at the level of C2 to C4 (Figure, A). The mass showed homogenous enhancement with gadolinium contrast (not shown).

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