PATHOLOGIC QUIZ CASE 1
John J. Conley, MD, Albert A. Clairmont, MD, New York
A 53-year-old woman began having some odynophagia on the left side and weakness to her voice in January 1976. The physical examination revealed a nonpulsatile mass pushing medially in the left tonsillar area (Fig 1). Also, in the left upper neck, behind the angle of the mandible, a 3 × 2-cm, palpable firm mass was obvious. There was no bruit, no cervical lymphadenopathy, and no other positive ENT findings. Arteriograms revealed a nonvascular mass in the left parapharyngeal area that uniformly constricted the common carotid artery (Fig 2 and 3).At surgery, following a preliminary tracheostomy, the lower lip was split in the midline and the cheek-upper neck skin flap was reflected superiorly. The mandible was transected at the angle for better viewing. The mass appeared well-encapsulated and seemed to arise from the vagus nerve, which
FECHNER RE. Resident's Page. Arch Otolaryngol. 1978;104(10):610–613. doi:10.1001/archotol.1978.00790100064016
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