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Clinical Challenge
April 2015

A Pediatric Soft Palate Mass

Author Affiliations
  • 1Department of Otolaryngology and Communication Enhancement, Boston Children’s Hospital, Boston, Massachusetts
  • 2Department of Neuroradiology, Boston Children’s Hospital, Boston, Massachusetts
  • 3Department of Pathology, Boston Children’s Hospital, Boston, Massachusetts

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JAMA Otolaryngol Head Neck Surg. 2015;141(4):391-392. doi:10.1001/jamaoto.2014.3722

A teenage girl presented with a 3-month history of a gradually enlarging soft palate mass associated with a change in her voice. She had no associated pain, difficulty swallowing, or difficulty breathing. She was otherwise healthy, with no medical or surgical history. Findings from her physical examination were unremarkable with the exception of a 2 × 2-cm firm, nontender, submucosal posterior soft palate mass just left of the uvula. There was no overlying ulceration or discoloration. Flexible nasopharyngoscopy was normal. Prior to presentation, a computed tomographic scan and biopsy had been performed at an outside hospital. Magnetic resonance imaging (MRI) of the face with contrast was also performed (Figure, A-C). Imaging showed a well-circumscribed solid lesion with no evidence of infiltration of soft-tissue structures, the pterygopalatine fossa, or palatine nerve foramina. There was no cervical lymphadenopathy. The lesion was resected via a transoral approach and was easily dissected from the surrounding tissue (Figure, D). The overlying mucosa was spared.

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