Type of publication:
Teo X.Y.; *Rafie A.; Thompson S.; Jolly K.; Darr A.
British Journal of Surgery, 2019, Volume 106, Issue S6, p. 72
Introduction: Haemangiomas are a rare entity and seldom observed within the cavern e.g. larynx. The rarity and nature of these lesions can result in clinical unpredictability and mortality. According to literature, laryngeal cavernous haemangiomas often present as dysphonia. However, we have documented a rare case of cavernous haemangioma presenting as dyspnoea. Case presentation: A 71-year old gentleman presented to the A&E with progressive breathlessness and a history of un-investigated intermittent dysphonia. Medical therapy for suspected heart failure and COPD was ineffective, with worsening stridor identified. Assessment by the Otolaryngology team elicited a pedunculated lesion of the vocal cord. An awake fibre-optic intubation was undertaken, under sedation while spontaneously respiring. The patient subsequently underwent urgent microlaryngoscopy to have the lesion resected. Discussion: Cavernous haemangiomas are relatively rare findings with less than 10 cases being documented in the literature. However, in this case, breathlessness was the main presenting complaint. Histological examination of cavernous haemangiomas demonstrated polypoid tissue surfaced by reactive squamous epithelium and underlying stroma containing large dilated vascular channels.
Conclusion: Laryngeal cavernous haemangiomas in adults are uncommon and rarely seen on the vocal cords. Although benign, their course can be unpredictable and airway obstruction can occur rapidly, warranting urgent
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