CASE HISTORY / CLINIC:
56-year-old patient with severe dysphagia and incipient shortness of breath.



FINDINGS:
Demonstration of an extensive, mainly left-sided contrast-enhancing mass on both sides of the epiglottis at the level of the hyoid. The mass seems to be confined to the epiglottis and only borders ventrally on the hyoid and dorsally on the posterior wall of the hypopharynx. The sheath of nerves and vessels has not been invaded. In the CT image done at a lower level after contrast administration (right) the epiglottic mass shows an inhomogeneous contrast enhancement.
Both images demonstrate some lymph nodes in the sheath of nerves and vessels
on the right side.


DIAGNOSIS:
Leiomyosarcoma of the epiglottis without evidence of pathological lymph nodes.



DIFFERENTIAL DIAGNOSIS:
Supraglottic squamous cell carcinoma