PATHOLOGIC QUIZ CASE 1
David E. Eibling, MD, Robert S. Rosnagle, MD, New Haven, Conn
A 46-year-old male nonsmoker came to his otolaryngologist with a one-year history of hoarseness. He denied dyspnea, dysphagia, otalgia, or weight loss. Indirect laryngoscopy revealed a bulging false vocal cord with a fixed true cord on the right side. Laryngeal tomograms (Fig 1) showed a mass involving the entire right hemilarynx. At laryngoscopy, no mucosal lesions were seen. The false cord area was cystic; it was incised and drained. The fluid that was collected showed no identifiable cells. Biopsy specimens of the cyst wall were negative for tumor.The patient's symptoms did not resolve, so one week later a thyrotomy was performed. A mass of white firm tissue (Fig 2) was removed in continuity with half of the cricoid ring. The cricoid ring was reconstructed with a pedicle flap of thyroid cartilage. The patient