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Radiology Quiz Case 2

Radiology Quiz Case 2 A 53-year-old white woman presented with a 1-week history of sore throat, hoarseness, odynophagia, and dysphagia. Her medical history was remarkable for diabetes mellitus. Indirect laryngoscopy revealed an erythematous mucosal-covered mass at the base of the tongue. Flexible laryngoscopy showed that the mass was 2 × 2 cm, raised, erythematous, nonulcerated, and situated in the midline of the base of the tongue. It was in contact with the posterior pharyngeal wall. On tongue protrusion, the mass moved away from the posterior pharyngeal wall, permitting adequate visualization of the vocal cords. The thyroid gland was just slightly palpable at its native location in the neck. An axial computed tomographic scan with contrast revealed a 2.5 × 3.0-cm well-circumscribed, enhancing lesion at the base of the tongue (Figure 1, arrow), extending from approximately the level of C3 to just above the epiglottis (Figure 2, arrow). An iodine 123 scan demonstrated functioning tissue in the left upper thyroid lobe. There was no clinical uptake in the rest of the gland, nor was there any evidence of the presence of the right lobe. Hematologic examination showed normal thyrotropin and microsomal antibody levels. The patient underwent direct laryngoscopy with biopsy of the base of the tongue mass, transhyoid pharyngotomy with wide local excision of the base of the tongue mass, and tracheostomy. Histologic examination of the tongue lesion revealed tissue suggestive of nodular hyperplasia (Figure 3). Figure 1. View LargeDownload Figure 2. View LargeDownload Figure 3. 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 53-year-old white woman presented with a 1-week history of sore throat, hoarseness, odynophagia, and dysphagia. Her medical history was remarkable for diabetes mellitus. Indirect laryngoscopy revealed an erythematous mucosal-covered mass at the base of the tongue. Flexible laryngoscopy showed that the mass was 2 × 2 cm, raised, erythematous, nonulcerated, and situated in the midline of the base of the tongue. It was in contact with the posterior pharyngeal wall. On tongue protrusion,...
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Publisher
American Medical Association
Copyright
Copyright © 2007 American Medical Association. All Rights Reserved.
ISSN
0886-4470
DOI
10.1001/archotol.133.8.835
pmid
17709628
Publisher site
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Abstract

A 53-year-old white woman presented with a 1-week history of sore throat, hoarseness, odynophagia, and dysphagia. Her medical history was remarkable for diabetes mellitus. Indirect laryngoscopy revealed an erythematous mucosal-covered mass at the base of the tongue. Flexible laryngoscopy showed that the mass was 2 × 2 cm, raised, erythematous, nonulcerated, and situated in the midline of the base of the tongue. It was in contact with the posterior pharyngeal wall. On tongue protrusion, the mass moved away from the posterior pharyngeal wall, permitting adequate visualization of the vocal cords. The thyroid gland was just slightly palpable at its native location in the neck. An axial computed tomographic scan with contrast revealed a 2.5 × 3.0-cm well-circumscribed, enhancing lesion at the base of the tongue (Figure 1, arrow), extending from approximately the level of C3 to just above the epiglottis (Figure 2, arrow). An iodine 123 scan demonstrated functioning tissue in the left upper thyroid lobe. There was no clinical uptake in the rest of the gland, nor was there any evidence of the presence of the right lobe. Hematologic examination showed normal thyrotropin and microsomal antibody levels. The patient underwent direct laryngoscopy with biopsy of the base of the tongue mass, transhyoid pharyngotomy with wide local excision of the base of the tongue mass, and tracheostomy. Histologic examination of the tongue lesion revealed tissue suggestive of nodular hyperplasia (Figure 3). Figure 1. View LargeDownload Figure 2. View LargeDownload Figure 3. View LargeDownload What is your diagnosis?

Journal

Archives of Otolaryngology–Head & Neck SurgeryAmerican Medical Association

Published: Aug 1, 2007

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