HighlightsA 62 year old man without any history of trauma presented with progressive dysphonia, dyspnoea, without any dysphagia.A fibreoptic laryngoscopic examination revealed nodular mass arising at the junction of posterior 1/3rd and middle 1/3rd of left vocal cord it was extending up to arytenoids.A computed tomography scan of the neck region showed a rounded and circumscribed mass without infiltration of the surrounding tissues. Histological investigation of the lesion revealed the presence of fibroelastic cartilaginous tissue, surrounded by a thin rim of fibrous tissue, with rare hypercellular areas, occasional binucleated cells, slight hyperchromasia, and an irregular nuclear profile. Mitotic activity was absent.Sub acute and progressive onset of clinical symptoms and histological and radiological findings helps to distinguish the chondrometaplastic nature of this nodule from true laryngeal cartilaginous tumours, such as chondroma and low grade chondrosarcoma.The recognition of chondrometaplasia is important because of its occasionally troublesome differential diagnosis from true cartilaginous neoplasms of the larynx, such as chondroma and low grade chondrosarcoma.
Keratosis obturans is an obscure entity characterized by accumulation of desquamated keratinous material in the bony portion of the external auditory canal. Patients with this condition typically present with severe otalgia, conductive hearing loss, and global widening of the external auditory canal. We present a case of keratosis obturans that was misdiagnosed as impacted wax. The case was diagnosed and managed by microscope-guided examination with the patient under general anesthesia.
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