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Clinical Problem Solving: Pathology
December 2005

Pathology Quiz Case 2

Author Affiliations

Copyright 2005 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2005

Arch Otolaryngol Head Neck Surg. 2005;131(12):1121. doi:10.1001/archotol.131.12.1121

A 27-year-old woman with a history of multiple sclerosis underwent a routine screening magnetic resonance imaging of the brain, which revealed a 4 × 3-cm brightly enhancing left prevertebral/parapharyngeal mass spanning the second through the fourth cervical vertebral bodies (Figure 1). The patient was asymptomatic and denied otalgia, dysphagia, odynophagia, voice changes, ptosis, anhydrosis, diaphoresis, palpitations, or tremors. Her medical history was significant only for multiple sclerosis, which was stable on a regimen of interferon beta-1a (Avonex), her only medication. Physical examination revealed a bulge in the left posterior oropharynx that was palpable on bimanual examination, just posterior and inferior to the angle of the left mandible. There was no associated cervical adenopathy, and there were no cranial nerve deficits.

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