Figure 9.

Patient presenting with hoarseness, dyspnea and pain in the laryngeal region, 14 years after radiotherapy for laryngeal cancer. The CT images (section B was obtained 5 mm below section A) show fragmentation of the anterior part of the thyroid cartilage (arrowhead), intra- and extralaryngeal soft tissue thickening, including a small prelaryngeal enhancing area with central fluid density, possibly corresponding to a small abscess (arrow). This study was reported as suggestive for laryngeal necrosis. A FDG–PET study at that time was negative. Conservative treatment was initiated, with gradual improvement of the symptoms; this evolution corroborates the hypothesis of (limited) laryngeal necrosis.