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Clinical Problem Solving: Pathology
June 20, 2011

Pathology Quiz Case 3

Author Affiliations
 

JULIA C.IEZZONIMD

Arch Otolaryngol Head Neck Surg. 2011;137(6):637. doi:10.1001/archoto.2011.73-a

A 2-year-old girl with a history of persistent noisy breathing after a presumed episode of croup was referred to our institution for an evaluation of her airway. Her medical history was unremarkable. On physical examination, she was breathing comfortably but exhibited mild inspiratory stridor. Numerous café au lait spots and freckling were seen on her neck, chest, axillae, and back. Flexible nasolaryngoscopy revealed a 3 × 3-cm submucosal mass originating from the left aryepiglottic fold and obscuring visualization of the left vocal cord and distal airway. Magnetic resonance imaging demonstrated a homogeneously enhancing 4 × 2 × 3-cm irregular mass involving the left epiglottis and aryepiglottic fold, with fingerlike extensions into the left pyriform sinus and lateral paraglottic tissues (Figure 1).

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