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Clinical Challenge
June 2015

Foreign Body Sensation in the Throat

Author Affiliations
  • 1Department of Otorhinolaryngology—Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
  • 2Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
  • 3Department of Pathology, National Yang-Ming University School of Medicine, Taipei, Taiwan
  • 4Department of Otorhinolaryngology, National Yang-Ming University School of Medicine, Taipei, Taiwan
JAMA Otolaryngol Head Neck Surg. 2015;141(6):581-582. doi:10.1001/jamaoto.2015.0390

A man in his 40s with a 10-year history of smoking 180 packs of cigarettes per year choked easily and had experienced a foreign body sensation in his throat for 6 months. He was a tour guide, a profession that requires speech. Because he experienced voice fatigue frequently, he visited a hospital for professional assistance. Fibroscopy showed a well-circumscribed mass of approximately 3 × 3 × 2 cm, with a smooth surface, located at the laryngeal side of the left aryepiglottic fold and covering nearby structures, such as the bilateral vocal cords and left pyriform sinus (Figure 1, A). A biopsy was performed, and the patient visited our institution (Taipei Veterans General Hospital) for further intervention. The laryngeal mass was removed through transoral laser microsurgery. The tumor was at the submucosa with focally ulcerated overlying epithelium. It was composed of adipocytes of various sizes in a fibromyxoid background. In the fibromyxoid areas, atypical spindle cells with hyperchromatic and enlarged nuclei were present, as well as scattered lipoblasts without areas of dedifferentiation (Figure 1, B). Immunohistochemically, the tumor exhibited substantial nuclear staining for both CDK4 and MDM2 and stains (Figure 1, C).

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