4th Edition

Chapter 20: The priest with bad breath

A 66-year-old Catholic priest complained of halitosis (to be honest his parishioners complained more than he did). He smoked two packets of cigarettes a day and it was widely believed that he drank more of the communion wine than he blessed. When his doctor examined him there was a painless swelling on the left side of his hard palate with a central area of ulceration.

He was referred to the ENT consultant who arranged a CT scan.

  • 1. What does the CT scan show?

    Correct answer:

    Soft tissue mass with ipsilateral lymphadenopathy.

A biopsy of the mass was performed that confirmed squamous cell cancer of the oral cavity.

He next had a CT-PET scan.

  • 2. What does the CT-PET show?

    Correct answer:

    Both the primary tumour and the lymph nodes were avid on FDG-PET. The tumour staging was pT2N3M0. are all associated with a higher risk of ovarian cancer.

He was treated with extensive surgical resection and reconstruction followed by adjuvant radiotherapy. He never delivered another sermon.

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