Presentation
Hoarseness and diplopia.
Patient Data
Soft tissue mass centered on the lateral and posterior hypopharyngeal walls and extending up into the distal right posterolateral oropharyngeal wall. No lymphadenopathy.
Soft tissue mass in subcutaneous tissues overlying the left body of mandible..
The soft tissue along the infero-medial aspects of bilateral orbits is unchanged. It is both intraconal and extraconal on the right.
Opacification of the right maxillary sinus with central high density material is unchanged in appearance.
Conclusion:
Right postero-lateral pharyngeal and bilateral orbital masses, consistent with lymphoma.
Case Discussion
The differential diagnosis of a soft tissue mass in the oropharynx/hypopharynx is squamous cell carcinoma and lymphoma.
Soft tissue masses in both orbits include lymphoma or pseudo-tumors. Metastases from carcinoma and melanoma should also be considered.
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