1. Head and Neck case

2. 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

3. 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).

5. 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.

6. CXR: no abnormal nodular lesion noted

7. Sonography of upper abdomen showed:

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

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

11. 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