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A 24-year-old woman presented to the emergency department with a 1-week history of shortness of breath at rest. She also had a 3-month history of odynophagia, and her voice had become increasingly hoarse. On physical examination, no intraoral masses or lesions were seen or palpated. The patient's neck was soft and flat, with no adenopathy. There was soft inspiratory stridor at rest. Her voice was clear, although it had a slightly harsh quality. Flexible fiberoptic laryngoscopy demonstrated a large exophytic fleshy mass emanating from the right arytenoid. The mass obstructed the laryngeal inlet, obscuring the true vocal cords (Figure 1).
Hsia JC, Schmitt NC, Hoch B, Moe KS. Pathology Quiz Case 1. Arch Otolaryngol Head Neck Surg. 2011;137(6):635. doi:10.1001/archoto.2011.71-a