Pathologic Quiz Case 1
Thomas R. Neuman, MD, San Diego, CalifA 2.5-year-old white girl presented with a 7-month history of a slowly enlarging mass in the left side of her neck. The mass had been unresponsive to multiple antibiotic trials. Other symptoms included increased snoring, noisy breathing, and, recently, occasional apnea during sleep. The patient's history was not significant for dysphagia, odynophagia, or weight loss.On physical examination, a 4 × 3-cm firm, ill-defined mass was found in the left side of the neck under the sternocleidomastoid muscle. There was a slight fullness in the left tonsillar region; however, there was no evidence of adenotonsillar hypertrophy. All cranial nerves were functional.Magnetic resonance imaging disclosed a 5×5×3-cm left parapharyngeal space tumor, extending to the skull base (Fig 1). Roentgenography of the chest, computed tomography of the chest and abdomen, a bone scan, and a bone survey revealed no abnormalities.
RESIDENT'S PAGE: PATHOLOGY. Arch Otolaryngol Head Neck Surg. 1993;119(7):792–795. doi:10.1001/archotol.1993.01880190088019