Clinical Problem Solving: Radiology
August 2004

Radiology Quiz Case 2

Author Affiliations



Copyright 2004 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2004

Arch Otolaryngol Head Neck Surg. 2004;130(8):997. doi:10.1001/archotol.130.8.997

A 71-year-old white woman presented with a 6-month history of dysphagia and a swelling in the right side of her throat. She was otherwise healthy. Physical examination of the oral cavity revealed a mass that began behind the right tonsil and extended medially and upward to the nasopharynx. The mass, which was entirely submucosal, was soft on palpation. There was no nodularity associated with the mass, and there was no palpable cervical adenopathy of the neck. The results of the rest of the physical examination were normal. T1- and T2-weighted sagittal, axial, and coronal plane magnetic resonance images (MRIs) were obtained. The MRIs showed a 5.5 × 4.5 × 3.5-cm, well-defined, lobulated mass, which demonstrated high intensity on T1-weighted images, in the right parapharyngeal area. The mass, which did not invade the surrounding spaces, had internal septa but no malignant features (Figure 1, Figure 2, and Figure 3). It was excised using blunt dissection via a transcervical approach. Histologic examination showed a benign mass consisting of mature adipose tissue cells separated by fibrovascular septa and a circumscribed fibrous capsule. The histologic findings are shown in Figure 4.

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