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A 28-year-old woman presented with a 6-month history of a visible mass at the base of her tongue. In addition to a lifelong history of loud snoring with occasional gasping, she reported shortness of breath, which was worse when she was lying flat. She also reported a chronic cough and a history of weight gain. She denied having otalgia, odynophagia, dysphagia, change in voice, or stridor.
Physical examination revealed an obese, nonstridorous woman. Oral cavity examination revealed macroglossia with a surgical absence of palatine tonsils. There was a large lingual tonsillar mass that became more prominent with tongue protrusion and was more prominent on the right side than on the left. The findings of the neck examination were unremarkable. Flexible nasolaryngoscopy revealed a base of tongue and vallecular mass completely filling the vallecula and pressing the epiglottis posteriorly. The vocal folds were normal in appearance and moved symmetrically.
Lalich IJ, Ward PD. Radiology Quiz Case 3. Arch Otolaryngol Head Neck Surg. 2011;137(6):630. doi:10.1001/archoto.2011.83-a