A CASE OF SUPRAGLOTTIC HEMANGIOMA - A CASE REPORT

A 17year male came with complaints of Cough since three months of age with difficulty in swallowing for the past 3 years and noisy breathing for 10 days. He was treated as bronchial asthma elsewhere. On examination patient was in biphasic stridor. Examination of oropharynx showed pooling of saliva and indirect laryngoscopy was inconclusive. Urgent X ray soft tissue neck lateral view showed edema of supraglottis with prevertebral soft tissue widening. The differential diagnosis according to x ray were acute epiglottitis or retropharyngeal abscess or Vallecular cyst. Emergency tracheostomy was done. CT neck done was inconclusive and suggested biopsy and MRI. Direct laryngoscopy showed soft bluish lobulated mass arising from left arytenoids, left aryepiglottic folds projecting into hypopharynx and oropharynx with normal vocal cords. Biopsy taken was reported as hemangioma. MRI showed vascular mass in left posterolateral hypopharynx supplied by superior thyroid artery. Ligation of superior thyroid artery and Excision of hemangioma was done. The reasons for presenting this case is for the difficulty in initial diagnosis for cause of stridor and rarity of hemangioma larynx presenting in adolescence.