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Clinical Challenge
May 2016

Supraglottic Mass

Author Affiliations
  • 1Department of Otolaryngology–Head and Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
  • 2Department of Radiology, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
JAMA Otolaryngol Head Neck Surg. 2016;142(5):499-500. doi:10.1001/jamaoto.2015.3363

A man in his 50s was referred to the otolaryngology clinic because of a globus sensation in the throat and a 6-month history of throat pain. His medical history was significant for hypertension, dyslipidemia, and cigarette smoking. Flexible fiber-optic laryngoscopy revealed a 15-mm submucosal swelling in the right aryepiglottic fold. The vocal folds were free of lesions and had intact motion. Findings from the rest of the head and neck examination were unremarkable. A computed tomographic (CT) scan of the neck revealed a submucosal hypodense supraglottic mass on the right side that was compressing the airway. A magnetic resonance imaging study (MRI) of the neck demonstrated a soft-tissue mass measuring 27 × 17 mm and causing deviation of the right aryepiglottic fold medially and compressing the airway (Figure, A and B). The patient underwent direct laryngoscopy, and a submucosal mass was observed in the right aryepiglottic fold (Figure, C). The mass was dissected submucosally, excised completely, and sent for a histopathologic examination (Figure, D). Results from the S100 protein immunostain were positive. The postoperative course was uneventful, and after 5 months, the patient had no detectable laryngeal lesions and the vocal fold movement was intact.

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