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Clinical Problem Solving: Pathology
September 2006

Pathology Quiz Case 1

Author Affiliations


Arch Otolaryngol Head Neck Surg. 2006;132(9):1012. doi:10.1001/archotol.132.9.1012-a

A 69-year-old man presented with mild ankyloglossia and mild dysarthria, which were caused by a firm, submucosal mass in the anterior portion of his tongue. The mass involved the deep substance of the anterior portion of the tongue and extended into the floor of the mouth. The posterior portion of the tongue and tongue base was soft and mobile. There was no evidence of lymphadenopathy. Five months earlier, the patient had been diagnosed as having a pleural mesothelioma of the epithelioid subtype after he underwent an open biopsy and attempted decortication. He then elected to receive chemotherapy consisting of pemetrexed (Alimta) and cisplatin. He reported a 50 pack-year history of tobacco use and heavy ethanol consumption in the past but stated that he had not smoked cigarettes for 20 years and currently only occasionally ingested alcohol. Importantly, he denied previous asbestos exposure.