Week 430: Case 5

1. Presented by Peter Illei, M.D. and prepared by Hillary Ross, M.D.

72 y.o. white male patient status post radtiation therapy for base of tongue squamous cell carcinoma 15 years ago. On his last regular surveillance examination, he was noted to have an erythematous swollen larynx. The patient was assumed to have a laryngeal infection and placed on Augmentin. The symptoms continued for another month. A fungal infection was next considered, and the patient was placed on fluconazole. His redness and swelling improved partially, but nonetheless a CT scan was obtained which demonstrated a questionable base of tongue mass. The patient denies dysphagia, odynophagia or pain. He does state that the pitch of his voice has decreased somewhat. He denies any respiratory problems. At biopsy, a diffuse redness and mild swelling of the laryngeal mucosa was noted, but no mass lesion was identified.