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Radiology Quiz Case 2

Radiology Quiz Case 2 A 22-YEAR-OLD WOMAN presented to the emergency department with acute pain in the lateral aspect of the left side of her neck, dysphagia, slight dyspnea, and dysphonia of 2 hours' duration. She stated that a left cervical mass had suddenly developed and had enlarged. Indirect laryngoscopy revealed that the mass, which was hard, painful, and tender on palpation, was causing compression and displacement of the left hemilarynx. She also said that her mother had died of a spontaneous rupture of the splenic artery at the age of 31 years. An axial computed tomographic scan of the neck with contrast (Figure 1) showed a round 3 × 4-cm mass with well-defined limits in the left carotid space. The mass, which was weakly enhanced by the contrastagent, was compressing the larynx and the left jugular vein. The patient underwent orotracheal intubation and was admitted to the intensive care unit. She was discharged 3 days later. Nine days afterward, a magnetic resonance imaging scan (Figure 2) revealed that the mass, which had increased in size, had a hyperintense peripheral area corresponding to a mural thrombosis and a central area with heterogeneous signal intensity due to a turbulent pseudoaneurysm flow. The next day, an angio–computed tomogram (Figure 3) showed a vascular mass arising from the left internal carotid artery. Angiography and embolization of the left carotid pseudoaneurysm were performed (Figure 4), resolving the disease. Figure 1. View LargeDownload Figure 2. View LargeDownload Figure 3. View LargeDownload Figure 4. View LargeDownload What is your diagnosis? http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Otolaryngology - Head & Neck Surgery American Medical Association

Radiology Quiz Case 2

Abstract

A 22-YEAR-OLD WOMAN presented to the emergency department with acute pain in the lateral aspect of the left side of her neck, dysphagia, slight dyspnea, and dysphonia of 2 hours' duration. She stated that a left cervical mass had suddenly developed and had enlarged. Indirect laryngoscopy revealed that the mass, which was hard, painful, and tender on palpation, was causing compression and displacement of the left hemilarynx. She also said that her mother had died of a spontaneous rupture...
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Publisher
American Medical Association
Copyright
Copyright © 2003 American Medical Association. All Rights Reserved.
ISSN
0886-4470
eISSN
1538-361X
DOI
10.1001/archotol.129.5.595
Publisher site
See Article on Publisher Site

Abstract

A 22-YEAR-OLD WOMAN presented to the emergency department with acute pain in the lateral aspect of the left side of her neck, dysphagia, slight dyspnea, and dysphonia of 2 hours' duration. She stated that a left cervical mass had suddenly developed and had enlarged. Indirect laryngoscopy revealed that the mass, which was hard, painful, and tender on palpation, was causing compression and displacement of the left hemilarynx. She also said that her mother had died of a spontaneous rupture of the splenic artery at the age of 31 years. An axial computed tomographic scan of the neck with contrast (Figure 1) showed a round 3 × 4-cm mass with well-defined limits in the left carotid space. The mass, which was weakly enhanced by the contrastagent, was compressing the larynx and the left jugular vein. The patient underwent orotracheal intubation and was admitted to the intensive care unit. She was discharged 3 days later. Nine days afterward, a magnetic resonance imaging scan (Figure 2) revealed that the mass, which had increased in size, had a hyperintense peripheral area corresponding to a mural thrombosis and a central area with heterogeneous signal intensity due to a turbulent pseudoaneurysm flow. The next day, an angio–computed tomogram (Figure 3) showed a vascular mass arising from the left internal carotid artery. Angiography and embolization of the left carotid pseudoaneurysm were performed (Figure 4), resolving the disease. Figure 1. View LargeDownload Figure 2. View LargeDownload Figure 3. View LargeDownload Figure 4. View LargeDownload What is your diagnosis?

Journal

Archives of Otolaryngology - Head & Neck SurgeryAmerican Medical Association

Published: May 1, 2003

Keywords: diagnostic radiologic examination,radiology specialty

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