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Clinical Problem Solving: Pathology
March 15, 2010

Pathology Quiz Case 2

Author Affiliations

Copyright 2010 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2010

Arch Otolaryngol Head Neck Surg. 2010;136(3):311. doi:10.1001/archoto.2010.9-a

A 33-year-old woman presented with a 1-month history of voice change and swallowing dysfunction. She said that her voice had become weak and muffled. She also stated that she had progressive dysphagia with solids and odynophagia after she tried to swallow foods that she was accustomed to eating. Over the past 2 months, she had gained 8 kg. Furthermore, she said that she has to sleep upright because she becomes short of breath when she is lying supine. Her medical history was remarkable for hypothyroidism and a 40 pack-year smoking history. Physical examination revealed a firm mass to bimanual palpation on the base of the tongue (BOT), without palpable cervical lymphadenopathy. Nasopharyngoscopy demonstrated a smooth, midline, 2-cm-diameter BOT mass.