CASE OF CYSTIC ADENOMA OF BASE OF TONGUE ; WITH 
RETRO.PHARYNGEAL AND CERVICAL ADENOMA. 
Bv J. SOLIS-COHEN, M, D., 
PHILADELPHIA, 
A married woman, 40 years of age, applied in Febru- 
ary, 1880, to the Laryngoscopic Department of Jefferson Medical 
College Hospital, for relief from an impediment to speech and 
deglutition. 
Impairment of deglutition was reported as of fifteen years’ date, 
and impairment of articulation as of thirteen and a half years’ 
duration. There had been occasional attacks of what was diag- 
nosed as laryngitis ; generally in the spring and in the fall. 
My attention was called to the patient with word that a tumor 
of the epiglottis existed, which I was requested to remove ; and 
that there was an abcess of the pharynx on which my opinion was 
solicited. 
On laryngoscopic examination of the very well nourished and 
docile patient, I discovered an elongated globose tumor the size 
of a small grape, attached to the posterior portion of the root of 
the left side of the tongue, and lying in front of the epiglottis ; 
while a post-pharyngeal projection pressed close upon it from 
the junction of the posterior and lateral walls of the same side of 
the throat. 
Reprinted from Archives OF Laryngology, Yol. I, No. 3, September, 
1880. 2 
Clinical Notes. 
To seize this growth with a pair of ordinary dressing forceps 
and sever its connection from the tongue, was but the work of a 
moment ; and in a minute the impediment to articulation was 
overcome. The bleeding was insignificant and soon ceased spon- 
taneously, by which time it was evident that normal deglutition 
had become practicable. The laryngoscope now revealed a 
healthy larynx, with the left vocal band in the cadaveric position, 
indicative of complete paralysis of the recurrent laryngeal nerve of 
Cystic adenoma of root of tongue : with retro-pharyngeal adenoma ro the side. 
that side. Examination externally revealed a cervical tumor ex- 
tending three inches from just below the left ear, in an oblique 
direction closely corresponding with that of the anterior edge of 
the sterno-cleido-mastoid muscle, and in its broadest portion two 
inches and one tenth in diameter. The pulsation of the carotid 
artery was very perceptible on palpation of this growth. Internally 
the tumor projected into the pharynx to the bulk of a large 
almond ; and upon palpation there, the pulsation was still more 
perceptible. The patient reported that the external tumor was of 
five years’ growth, and had been preceded by a disagreeable 
feeling in the ear as though some muscle of the neck had been 
strained. Audition in this left ear was normal, while hearing was 
completely abolished in the right ear. 
Surgical interference with the cervico-pharyngeal growth was de- 
clined on my part as too hazardous ; an opinion in which I was 
confirmed by the judgment of ray colleague, Dr. S. W. Gross, of 
the surgical staff of the hospital. 
Dr. Seiler examined the growth, removed and pronounced it a 
cystic adenoma. 
At last date (August, 1880), the external tumor is slowly enlarg- 
ing ; and paralysis of the left side of the tongue, with atrophy, has 
become superadded to the paralysis of the left vocal band.