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Clinical Problem Solving: Radiology
April 19, 2010

Radiology Quiz Case 2

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Copyright 2010 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2010

Arch Otolaryngol Head Neck Surg. 2010;136(4):412. doi:10.1001/archoto.2010.36-a

A 62-year-old woman presented with a 2-week history of a foreign body sensation and globus. She had been experiencing a major depressive syndrome for several years, and both she and her family physician reported a recent worsening of her psychiatric symptoms. Her medical history was otherwise noncontributory. She did not report any recent sore throat or fever. A retropharyngeal mass, which was noted during the oropharyngeal examination, was located posterior and medial to the left tonsillar fossa (Figure 1). The patient had a marked reflex, however, and was unable to tolerate a tongue depressor for long, so transnasal fiberoptic endoscopy was performed. A slight pulse of the mass was observed in the right posterior pharyngeal wall, synchronous with the patient's heartbeat. The pharyngeal mucosa seemed normal.

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