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November 1975

Resident's Page

Arch Otolaryngol. 1975;101(11):708-710. doi:10.1001/archotol.1975.00780400066021

PATHOLOGIC QUIZ CASE  Leonard P. Rybak, MD, MinneapolisA 28-year old man had a mass on the left side of his neck of one-year's duration. Rapid enlargement had occurred within the past one to two months before admission, resulting in wheezing and some shortness of breath. The patient's mother had been treated for benign goiter, but the family history was otherwise noncontributory. The patient had no complaints of pain, dysphagia, hoarseness, or cough. No symptoms of thyrotoxicosis or hypothyroidism were noted.Physical examination revealed a muscular man without dyspnea at rest. His voice had a "hot potato" quality, and there was a palpable nodule on the left thyroid gland. A separate, large, hard fixed left cervical lymph node was felt. The trachea was deviated to the right and stridor was audible. Results of indirect laryngoscopy were normal.Chest x-ray film revealed a tracheal shift to the right. Results of xeroradiography