A 64 year-old man is seen with a four-to sixweek history of right-sided sore throat. He is in otherwise good health, with a 20 pack-a-year history of tobacco use. The patient is otherwise asymptomatic.
Examination of the pharynx reveals a 3cm by 3cm mass located on the lateroposterior oropharyngeal wall. The lesion is primarily laterally based, beginning just behind the posterior tonsillar arch, extending to just behind the junction of the lateral and posterior wall. It is a raised, exophytic tumor with sharp borders. Inferiorly, the mass extends to a level just below the free border of the epiglottis to a superior margin at a level parallel to the hard palate, all margins are clearly visible intraorally. A 2cm discrete neck node is palpable in the ipsilateral jugulodigastric region.
It is nontender and freely mobile.
Examination of the chest is clear to auscultation and palpation. Results of the remainder of the physical examination are unremarkable. Chest x-ray reveals a solitary peripheral mass proven on biopsy to be neoplastic, most likely from the oropharyngeal primary.
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