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October 1984

Resident's Page

Author Affiliations

University of Virginia School of Medicine, Charlottesville

Arch Otolaryngol. 1984;110(10):698-700. doi:10.1001/archotol.1984.00800360070022


Robert E. Fechner, MD  A 42-year-old man had a three-month history of hoarseness. He had smoked two packs of cigarettes a day since age 14 years, and he drank at least one pint of whiskey a day. On direct laryngoscopy, a 2.5-cm mass was seen that filled the left pyriform sinus. A 2-cm lymph node was palpable on the left side of the neck. The patient underwent a total laryngectomy and a radical dissection of the left side of the neck.The clinically palpable lymph node contained metastatic squamous carcinoma histologically identical to the lesion in the larynx. No other lymph nodes contained neoplasms. One of the 42 remaining lymph nodes contained a focus, as seen in Fig 1. The lymph node was 5 mm in diameter and grossly normal. Figure 2, an illustration from another case, also will be discussed.What is your diagnosis?

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