Abstract / Summary
Abstract Background: Oropharyngeal tumors may initially present with nonspecific inflammatory symptoms, leading to diagnostic delay. Large exophytic lesions of the posterior pharyngeal wall are uncommon and may clinically and radiologically mimic infectious or inflammatory conditions. Case Presentation: We report the case of a 67-year-old male presenting with progressive dysphagia, intermittent dysphonia, and foreign body sensation in the throat. Initial clinical evaluation and histopathological examination suggested an inflammatory process. Contrast-enhanced computed tomography revealed a large polypoid mass arising from the posterior pharyngeal wall, extending to the left salpingopharyngeal fold and the hypopharynx, with craniocaudal extension of approximately 64 mm and significant airway narrowing. Repeat biopsy followed by surgical excision confirmed poorly differentiated oropharyngeal squamous cell carcinoma of the Regaud–Schmincke type with deep soft-tissue infiltration, including invasion of striated muscle and salivary gland parenchyma. Due to impending airway obstruction, protective tracheostomy was performed prior to surgery. The postoperative course was complicated by transient acute kidney injury, which resolved with conservative management. The patient subsequently completed adjuvant external beam radiotherapy and was successfully decannulated four months postoperatively. Follow-up imaging demonstrated no evidence of local recurrence or distant metastasis. Conclusion: This case highlights the diagnostic challenges posed by exophytic oropharyngeal carcinomas presenting with inflammatory features and underscores the importance of cross-sectional imaging and repeat histopathological evaluation in patients with persistent or progressive pharyngeal symptoms.