R. NICKBRYANMDS. JAMESZINREICHMD
A 16-YEAR-OLD girl presented with difficulty in swallowing that was caused by a rapidly increasing swelling of the floor of the mouth. She had become aware of this swelling 6 weeks earlier, but it had not become troublesome until shortly before presentation, when it enlarged more rapidly and started to interfere with swallowing. Physical examination revealed a large, nontender, fluctuant swelling filling the entire floor of the mouth. The results of the rest of the physical examination were normal. Aspiration of the swelling yielded 0.5 mL of amorphous material, which was reported as necrotic with no elements present for assessment.
Urso-Baiarda F, Saravanappa N, Courteney-Harris R. Radiology Quiz Case 1. Arch Otolaryngol Head Neck Surg. 2003;129(4):490. doi:10.1001/archotol.129.4.490