A lump in the throat

Abstract

A 73-year-old man with hypertension, gastroesophageal reflux disease, and no history of smoking, drinking, or previous cancer, presented to the emergency department at the University of California, Irvine Medical Center (Orange, CA, USA) after acute onset of a protruding oral mass, difficulty breathing, and dysphagia. The patient had been walking his dog on a leash when the dog jerked him forwards, resulting in an episode of coughing, choking, and emesis. Before this event, the patient reported intermittent dysphagia, and feeling as if something was stuck in his throat, which improved with swallowing. The incident while walking his dog caused dislodging of a large non-tender soft-tissue mass (figure A) into the oral cavity and out of his mouth. The patient had never experienced this before, although he did recall a couple of episodes of coughing after which he felt a lump in his throat that resolved. (A) Hypopharyngeal mass protruding from the mouth. The patient's tongue is inside of his mouth. (B) Endoscopic view of mass.