PATHOLOGIC QUIZ CASE 1
David B. Wexler, MD, Ruth Macke, MD, Iowa City, Iowa; Sanford M. Archer, MD, Lexington, Ky
A 59-year-old white man was evaluated for a left submandibular mass of approximately 2 months' duration. The patient denied pain and tenderness, and there was no change in the mass with eating. He had a strong smoking history. He also carried a diagnosis of right groin pull, made by the orthopedic consultants after an evaluation that included roentgenographic studies.
On physical examination, the patient had an approximately 5-cm non-tender, firm mass in the left submandibular region. Function of the ramus mandibularis nerve was intact. No cervical adenopathy was palpable.
The patient underwent a left submandibular gland excision. Postoperatively, persistent complaints of hip pain led to a second series of roentgenographic studies obtained approximately 3 weeks after the original series. New, advanced lytic lesions of the right pubic ramus
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