Head and Neck case

Clinical data 11073497 郭X義 52 y/o male Chief complaint: dysphagia for 1+ months. Other s/s: lumping throat(+), hoarseness(-), sputum(-), cough(-), sore-throat(-), , choking(-), odynophagia(-),voice abuse(-), nasal obstruction(-).  PE and laryngoscope: suspicious hypopharyngeal tumor.  Lab data: negative  CT study to confirm and stage for hypopharyngeal tumor

Imaging findings CT of H&N: Tumor (2x1x1cm) at the posterior hypopharyngeal wall with necrotic lymph node (2cm) at the Rt level III level. Also noted several bil. submandibular lymph nodes (1.1cm).

Imaging for staging CXR: no abnormal nodular lesion noted Sonography of upper abdomen showed: Hyperechoic right hepatic nodule, R/O hemangioma or metastasis. Recommend further study. Abdominal MRI for R/O hemangioma or metastasis of the liver: Favor hemangioma according to the findings.

CXR: no abnormal nodular lesion noted

Sonography of upper abdomen showed:

Abdominal MRI for R/O hemangioma or metastasis of the liver: Favor hemangioma according to the findings

Treatment course 術式 Laryngomicrosurgery + Esophagoscopy. pathologic report: Squamous cell carcinoma of the hypopharynx CCRT: 2005/08/25 - 2005/10/20

Follow-up neck CT after CCRT: 1. Posterior hypopharyngeal wall cancer s/p treatment with smaller in size. 2.The necrotic lymph node at the Rt level III level on previous CT is not seen this time