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Clinical Challenge
October 10, 2019

Recurrent Vocal Fold Mass in a Middle-aged Woman

Author Affiliations
  • 1Department of Otolaryngology–Head and Neck Surgery, Virginia Commonwealth University, Richmond
  • 2Department of Pathology, Virginia Commonwealth University, Richmond
JAMA Otolaryngol Head Neck Surg. 2020;146(1):71-72. doi:10.1001/jamaoto.2019.2869

A 45-year-old woman was referred to a tertiary care center for hoarseness. She had a left vocal fold polyp that was removed 2 months earlier at an outside institution, with benign pathology reported. Subsequent stroboscopy revealed a hemorrhagic-appearing polyp (2-3 mm). She was sent for preoperative voice therapy, with plans for excision. However, her voice worsened with therapy, and she returned to the otolaryngology clinic after a few weeks. A larger, 6- to 7-mm, irregular, left vocal fold mass was noted. Preoperative imaging was nonspecific, revealing a small soft-tissue density along the true vocal fold. The patient was taken to the operating room for excision (Figure, A). After the final pathology results were obtained, the patient was taken back to the operating room for cordectomy with negative margins.

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