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An 80-year-old man presented with a lesion that had been observed on magnetic resonance images (MRIs) of his head and neck. The MRIs had been obtained because of reduced motility of the patient's left eye and left facial weakness. Six months earlier, he had developed otitis externa maligna with a partial facial nerve palsy and had undergone a mastoidectomy with a radical cavity on the left. Physical examination revealed a unilateral bulge of the left soft palatine arch that was obstructing the nasopharynx and the oropharynx. The mass was not pulsatile, and fluid could not be aspirated on puncture. Also, there was paralysis of the left abducens nerve and the left vocal fold. Ear microscopy showed an unirritated radical cavity. The patient appeared somnolent and disoriented, without signs of pain.
Koehler C, Warmuth-Metz M, Mlynski R. Radiology Quiz Case 1. Arch Otolaryngol Head Neck Surg. 2010;136(5):518. doi:10.1001/archoto.2010.60-a