Adult cavernous haemangioma of the vocal cords with a unique presentation of acute respiratory distress: a case report (2020)

Type of publication:
Journal article

Author(s):
*Rafie, A; Jolly, K; Darr, A; *Thompson, S

Citation:
Annals of the Royal College of Surgeons of England; Sep 2020; vol. 102 (no. 7); p. e152

Abstract:
Laryngeal haemangiomas can commonly be seen in children, and first-line treatment is usually propranolol. However, in adults, cavernous haemangioma of the vocal cord(s) is an extremely rare condition – with this being the only published adult case presenting with acute respiratory distress – the mainstay of treatment is surgical excision under microlaryngoscopy. Presentation in adults can be unpredictable, but primarily consists of hoarseness which can be associated with, dyspnoea, dysphagia, and haemoptysis – and in one documented case stenosis of the aero-digestive tract led to death. Due to these airway difficulties, surgery can often prove challenging. In this study, we explore the unusual case of a previously well 71-year-old gentleman presenting to the Emergency Department, with worsening shortness of breath as his primary complaint. Uniquely, in this case, an awake fibre-optic intubation was undertaken to manage the difficult airway and a microlaryngoscopy was performed. A 20x10x15 mm lesion was excised, which had characteristics in keeping with a cavernous haemangioma on microscopic examination.

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