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February 1968

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Arch Otolaryngol. 1968;87(2):210-213. doi:10.1001/archotol.1968.00760060212021

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George W. Shorago, MD, Miami, Fla  After having a cold with nasal stuffiness and hoarseness, a 50-year-old white woman complained of a "scratchiness" in her throat for approximately four weeks. She denied dyspnea, dysphagia, odynphagia, anorexia, malaise, or weight loss. She described her vocal quality at the time of initial examination as her normal and usual voice. The patient was a nonsmoker.Indirect laryngoscopy revealed a discrete area of black pigmentation involving the posterior hypopharyngeal wall beginning at the midepiglottic level and extending inferiorly below the level of the arytenoid. A multihued, darkly pigmented nodule approximately 8 mm in diameter was seen in the right aryepiglottic fold. A separate discrete nodule was noted on the lingual surface of the epiglottis. The right ventricular band, quadrangular membrane, and aryepiglottic fold were similarly involved by gray-black pigmentation. Both cords moved well. Mirror examination of the nasopharynx revealed a

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