FREDERIC B.ASKINMDWILLIAM H.WESTRAMD
A 54-YEAR-OLD white woman presented with a 6-month history of intermittent hoarseness and a sensation of pressure in the left side of her neck. She denied any history of trauma or symptoms of dysphagia, dyspnea, or hemoptysis. She received antibiotics and steroids from her primary care physician, without resolution of symptoms. Her medical history was significant for multinodular goiter, gastroesophageal reflux disease, and a 50-pack-year smoking history.
Indirect examination of the larynx revealed a submucosal mass filling the left vallecula and extending inferiorly to involve the left aryepiglottic fold and the false cord displacing the larynx to the right. A polypoid mass was seen protruding from the left ventricle, obstructing the view of the anterior left true vocal fold. True vocal fold motion was intact bilaterally. No lymphadenopathy or masses were observed on the neck examination, and the findings of the remainder of the head and neck examination were normal. A computed tomographic scan of the neck (Figure 1) revealed a 3 × 2-cm, well-circumscribed, nonenhancing, supraglottic mass without bony or cartilaginous destruction.
Wilson CJ, Woodroof JM, Tsue TT. Pathologic Quiz Case 1. Arch Otolaryngol Head Neck Surg. 1999;125(4):462. doi:10.1001/archotol.125.4.462