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Clinical Challenge
November 2015

A Submucosal Retropharyngeal Pulsatile Mass

Author Affiliations
  • 1Department of Sense Organs, Ear, Nose, and Throat Section, “Sapienza” University of Rome, Rome, Italy
  • 2Department of Surgical Science, Sapienza University of Rome, Rome, Italy
JAMA Otolaryngol Head Neck Surg. 2015;141(11):1027-1028. doi:10.1001/jamaoto.2015.2398

A woman in her 70s was referred to our hospital for evaluation of a dry cough, foreign body sensation in the throat, and mild dysphagia of 2 months’ duration. She had no dyspnea or hoarseness. Her medical history included hypertension, diabetes mellitus, and right-sided chronic otitis media of 4 years’ duration successfully treated surgically 1 year earlier (tympanoplasty type 1). On oral endoscopic examination, mild bilateral hyperemia of the tonsillar area and posterior pharyngeal wall were noted. A submucosal pulsatile mass was clearly visible in the right retropharyngeal area (Figure, A and B; Video). The base of tongue was normal. No other clinically significant abnormalities were noted. Part of the clinical findings were suggestive of laryngopharyngeal reflux disease, and oral esomeprazole, 40 mg/d, was prescribed. Head and neck magnetic resonance angiography was recommended (Figure, C and D). She was reevaluated after 15 days.

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