Wk 5, Case 4 - Review

Patient History
Hoarseness.

Findings
Contrast-enhanced CT was performed from the skull base to the thoracic inlet. The study demonstrates an approximately 1.5 cm low-attenuation lesion involving the left aryepiglottic fold which is predominantly low attenuation. The mass extends into the left paraglottic space and partially effaces the left piriform sinus. The superior aspect of the mass extends from the left aryepiglottic fold and extends into the lateral aspect of the pre-epiglottic space. Inferiorly, the mass extends to the left aryepiglottic fold and effaces the left laryngeal ventricle. No evidence of aggressive lesions are identified involving the true vocal cord. Bone algorithm shows no obvious evidence of cartilage erosion.

No evidence of enlarged lymph nodes are identified based on standard size criteria. Scattered vascular calcifications involving the base of the neck.

Visualized portion of the brain shows prominence of the sulci and ventricles. However, dedicated brain imaging is necessary for complete diagnostic evaluation.

Visualized portion of the lungs is grossly within normal limits. However, dedicated chest CT is necessary for complete diagnostic evaluation.

Conclusions
Approximately 1 cm predominantly low attenuation mass involving the left aryepiglottic fold with involvement of the left paraglottic space. These findings are consistent with fluid-filled internal laryngocele. These findings can also be seen in a submucosal neoplasm which could include squamous cell carcinoma or minor salivary gland tumor. The fact that the lesion is nonenhancing makes unusual lesions such as laryngeal paraganglioma less likely.