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Clinical Challenge
November 27, 2019

An Osseous Destructive Mass of the Infratemporal Fossa

Author Affiliations
  • 1Department of Otolaryngology–Head and Neck Surgery, Carver College of Medicine, University of Iowa, Iowa City
  • 2Department of Neurosurgery, Carver College of Medicine, University of Iowa, Iowa City
JAMA Otolaryngol Head Neck Surg. 2020;146(2):194-195. doi:10.1001/jamaoto.2019.3390

A 69-year-old man with a history of metastatic squamous cell carcinoma in the left parotid gland had undergone left parotidectomy and modified neck dissection followed by adjuvant radiation therapy 12 years previously. Ten years later, he developed a second primary tumor in the hypopharynx requiring total laryngectomy and bilateral neck dissection. He presented with new-onset headaches, left ear pain, and persistent unsteadiness during the previous month. There was no palpable lymphadenopathy, neurological deficits, or mastoid tenderness, and otoscopic examination results of the tympanic membrane appeared normal.

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