Malignant neoplasm of pyriform sinus

C12

Clinical Vignette:

Patient Profile:

* Age: 64 years old

* Sex: Female

* Name: Lillian

* Occupation: Retired opera singer

* Location: Europe

History of Present Illness:

Lillian, a retired opera singer who once enthralled audiences with her powerful and melodious soprano voice, found herself struggling with a mysterious hoarseness that refused to go away. The change began subtly, a slight raspiness at the end of the day, but over the course of six months, it became a persistent concern.

At first, she attributed the hoarseness to her years of singing, assuming it was a natural result of aging and vocal wear. However, the problem soon escalated. She began to experience pain and difficulty swallowing, even when consuming soft foods or liquids.

Lillian's family, noticing her discomfort and weight loss, urged her to seek medical attention. She reluctantly agreed, fearing the worst but hoping for a simple solution.

Physical Examination:

Upon physical examination, the ENT specialist noted asymmetry in the hypopharynx. Indirect laryngoscopy revealed a suspicious mass in the pyriform sinus, and the rest of the examination was unremarkable.

Investigations and Diagnosis:

A CT scan of the neck was promptly ordered, showing an irregular, enhancing mass in the left pyriform sinus. Biopsy was performed, and the histopathology report confirmed a diagnosis of squamous cell carcinoma.

The case was discussed in a multidisciplinary tumor board, and a treatment plan was outlined, including surgery, radiation, and possible chemotherapy, depending on the staging and resectability of the tumor.

Lillian and her family were informed of the diagnosis, and they braced themselves for the treatment journey ahead. The healthcare team assured them of their commitment to personalized care and provided resources to support Lillian during this challenging time.

Diagnosis and ICD-10-CM Code:

Malignant neoplasm of pyriform sinus (C12)