R. NICKBRYANMDS. JAMESZINREICHMD
A 48-YEAR-OLD woman presented with a 3-day history of dysphagia and dysphonia. Physical examination showed induration and fullness at the base of the tongue. The submandibular and submental regions were tender. The patient was afebrile and had a slightly elevated white blood cell count (17.2×109/L). The medical history was unremarkable.
A contrast-enhanced computed tomographic scan of the neck was performed (Figure 1). Magnetic resonance imaging (MRI) with gadolinium was performed for further evaluation (Figure 2 and Figure 3). Direct laryngoscopy with incisional biopsy was performed (Figure 4).
Gray GG, Voigt E, Breuer F, Rothman LM. Imaging Quiz Case 2. Arch Otolaryngol Head Neck Surg. 1999;125(5):593. doi: