The patient was a forty-year-old man who could not speak easily . He had a nasal voice , and in order to speak with a more expressive voice he bent his head forward especially to pronounce long vowels . From the beginning , it was clear that he must have a blockage in his mouth or pharynx but his mouth did not smell bad . He had been visited for four months in the clinics and offices and he was discharged with a large number of antibiotics each time . By examining the pharynx , it was found that a large mass was hanging from the soft palate in such a way that it occupied about eighty percent of the oral cavity . One could imagine that behind the pharynx and towards the nose , a lot of space was occupied by the mass . I took a picture of the throat and made a short video of the patient’s speech , but unfortunately due to a software problem , the gallery of my mobile phone was deleted and I did not have any images when I was going to post this article . There’s no lymphadenopathy at the neck or supraclavicular region .
In the first visit , I asked for a CT without contrast . You can see the result and image . I referred the patient to a university hospital and after a couple of days I called his number to follow up the patient’s condition . For three consecutive days he was out of reach the whole time . I hope he listened to my strict advice because in Iran , the biggest problem in treating patients is that the doctor’s recommendation is the last criterion for the patient to make a decision .
Differential diagnosis :
Pleomorphic adenoma
Large B cell lymphoma
Giant nodule
