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July 1986

Resident's Page

Author Affiliations

University of Virginia School of Medicine, Charlottesville

Arch Otolaryngol Head Neck Surg. 1986;112(7):780-783. doi:10.1001/archotol.1986.03780070092020

PATHOLOGIC QUIZ CASE 1  James C. Hertenstein, MD, Charlottesville, VaA 63-year-old retired coal miner with a 40-pack-year history of tobacco use complained of pharyngodynia and odynophagia of one month's duration. No cause was found, and he was referred to an otolaryngologist, who found no lesions on examination of the pharynx and the larynx. He was treated with penicillin and prednisone, without resolution of symptoms. Three weeks later he underwent triple endoscopy, and the findings were unremarkable. His symptoms progressed, and he then began to expectorate blood-tinged mucus after attempting to swallow coarse foods. An elder brother had had a carcinoma of the larynx. In light of this fact and his worsening symptoms, he was referred to the otolaryngologist who had previously diagnosed his brother's condition. Indirect mirror examination revealed a raised, erythematous, nonulcerated lesion of the laryngeal surface of the epiglottis, extending from just above the anterior commissure onto