PMC3965947_01
Initial examination findings. Arrowheads indicate a tumor lesion on the posterior wall of the hypopharynx.
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fig1
During the initial examination, a tumor lesion was found on the posterior wall of the hypopharynx (Figure 1).
Magnetic resonance T1-weighted, contrast-enhanced image at the first admission. Tumor lesion infiltrated from the posterior wall of hypopharyngeal to the prevertebral muscles.
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fig2
Enlargement of bilateral retropharyngeal lymph nodes was seen on computed tomography (CT), whereas on magnetic resonance imaging (MRI), lesion infiltration from the posterior wall of hypopharynx to the prevertebral muscles was observed (Figure 2).
Magnetic resonance T1-weighted, contrast-enhanced image at the time of the third admission. Arrows indicate high signal on vertebrae C4-C7. Arrow heads indicate an epidural abscess.
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fig3
CRP level of 17.7 mg/dL, suggesting a strong inflammatory reaction; however, no accumulation was observed on bone scintigraphy. Cervical spine osteomyelitis and an epidural abscess on C4-C7 were observed on MRI (Figure 3).
(a) Before initiating hyperbaric oxygen therapy (HBO). (b) After 7 rounds of HBO. (c) After 25 rounds of HBO. The abscess gradually reduced in size and had almost disappeared by the completion of HBO.
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fig4
The abscess gradually reduced and muscle strength improved, and the patient was subsequently discharged (Figure 4).