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Clinical Challenge
July 30, 2020

Incidental Thyroid Mass in a Patient With Oropharyngeal Squamous Cell Carcinoma

Author Affiliations
  • 1Division of Otolaryngology–Head and Neck Surgery, University of Connecticut School of Medicine, Farmington
  • 2Department of Pathology and Laboratory Medicine, Hartford Hospital, Hartford, Connecticut
  • 3Connecticut Institute of Head and Neck Surgery, Hartford
JAMA Otolaryngol Head Neck Surg. 2020;146(9):859-860. doi:10.1001/jamaoto.2020.1616

A 71-year-old man with no history of smoking was referred to our tertiary center in August 2018 for an asymptomatic left level 5 neck mass that had been present for 6 months. Biopsy of the mass demonstrated metastatic p16-positive (human papillomavirus [HPV]-related) squamous cell carcinoma. Examination revealed a large left base of tongue mass filling the vallecula. Computed tomography (CT) demonstrated an enhancing mass within the left base of tongue and bilateral cervical adenopathy. The patient was treated with concurrent radiation therapy and cetuximab, completing treatment without breaks in November 2018. His 3-month posttreatment fluorodeoxyglucose (FDG) positron-emission tomography/CT (FDG-PET/CT) imaging results demonstrated resolution of the activity at the base of tongue mass and the involved cervical lymph nodes, consistent with complete treatment response.

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