A man in his 60s presented with a 6-month history of dysphagia, a 3-month history of a 2.268-kg weight loss (to convert to pounds, divide by 0.454), and a right neck mass. Tobacco history was minimal and distant, and alcohol use was social only. Physical examination, including flexible nasolaryngoscopy, was notable for a large smooth nonulcerated right base of tongue mass with almost complete pharyngeal airway obstruction, and a 4-cm right level II lymph node. Computed tomography (CT) imaging revealed a 3-cm base of tongue–lingual tonsil mass with multiple right Ib, IIa, and II/III nodes, the largest of which was 2.0 cm by 3.0 cm. Awake tracheotomy and direct laryngoscopy with biopsy of right base of tongue mass lesion was performed.
Nuyen BA, Berry G, Megwalu U. Dysphagia and Pharyngeal Obstruction in a Nonsmoker. JAMA Otolaryngol Head Neck Surg. 2018;144(2):171–172. doi:10.1001/jamaoto.2017.2436
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