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Clinical Problem Solving: Radiology
May 2006

Radiology Quiz Case

Author Affiliations

Duke University Medical Center, Durham, NC

 

R. NICKBRYANMDPATRICIA A.HUDGINSMD

Arch Otolaryngol Head Neck Surg. 2006;132(5):559. doi:10.1001/archotol.132.5.559

A 28-year-old Hispanic woman presented with a 2-month history of progressive nasal obstruction, muffled voice, throat fullness, and an inability to sleep while supine because of obstructive symptoms. She had also lost 9 kg as a result of progressive dysphagia to solids. She denied having pain, fever, shortness of breath at rest, or chronic cough. She did not use tobacco or alcohol and had not been exposed to occupational toxins.

Physical examination revealed a soft tissue mass filling the entire oropharynx, with anterior displacement of the uvula and soft palate. On digital examination, the mass appeared to be distinct from the soft palate. Fiberoptic laryngoscopy revealed a soft tissue mass extending from the left maxillary sinus ostium, tracking posteriorly toward the nasopharynx, and extending to the level of the left pyriform sinus base. The vocal cords were easily visualized and mobile, and the results of the rest of the physical examination were normal.

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