Asymptomatic oropharyngeal lipoma complicating intubation

Lipoma at an unusual site - an intrinsic laryngeal lipoma involving the aryepiglottic fold

Lipomas are common tumours. However. they are a rare occurrence in the larynx. They are an unusual cause for hoarseness of voice and may at times present acutely with respiratory distress due to significant airway compromise. The characteristic imaging features help to differentiate it from laryngeal malignancy and other common pathologies. We present a case of a laryngeal lipoma arising from the aryepiglottic fold, which was diagnosed on imaging and confirmed on histopathological examination after surgical excision. We also briefly discuss the differential diagnosis of this entity.

Spindle Cell Lipomas of the Respiratory Tract: A Case Report and Comprehensive Literature Review

BACKGROUND

Spindle cell lipomas (SCLs) are benign tumors that are characteristically present on the upper back and neck, but in rare cases present throughout the respiratory mucosa, causing hoarseness, stridor, dyspnea, and obstruction.

OBJECTIVE

To highlight the importance of considering SCL in the diagnosis of benign respiratory tract tumors, a literature review identified all published cases of respiratory tract SCLs, including 2 from our institution: one case in the nasopharynx and 1 in the nasal valve.

METHODS

All case reports, series and literature reviews from the English literature from 1975 through March 2018 were systematically identified for review in the MEDLINE, EMBASE, and Scopus databases. Two additional cases from our institution were described.

RESULTS

In total, 24 cases of SCL in the respiratory tract were identified for review. Two cases from our institution are described here, bringing the total of reported cases to 26. Extensive analyses of oral cavity SCLs already exist, so we excluded this site from our review and focused on sites where SCLs may present with respiratory symptoms. Excluding the oral cavity and oropharynx, the most common location described is the larynx. All 26 cases were treated with excision. One tumor required a second surgery, but there were no other complications nor recurrences.

CONCLUSION

Although rare, SCLs may arise from throughout the respiratory tract and cause dyspnea, hoarseness and stridor. Spindle cell lipoma should be considered in the differential diagnosis of a respiratory tract mass. This diagnosis confers a good prognosis and patients may be reassured that surgery is almost always curative.

Lipoma of vallecula-a case report

Lipomas of the larynx, oropharynx and hypopharynx are rare, accounting for approximately 1% of benign laryngeal neoplasms. We present a rare case of a simple lipoma arising from the right vallecula. A 55-year-old male presented with worsening dysphagia for 1 week. CT scan revealed a lesion of fat attenuation in the right vallecula. The patient underwent surgical excision and recovered uneventfully. To our knowledge, there are only two cases of vallecular lipoma that have been reported and they are both of spindle cell subtype and located on the left side. This is the first reported case of a simple lipoma arising from the right vallecula and causing obstructive symptoms. CT scan or MRI is essential in confirming the diagnosis and assessing the extent, thus allowing prompt excision, especially when the patient is symptomatic.

Acute stridor caused by a previously asymptomatic large oropharyngeal spindle cell lipoma

Lipomas of the larynx, oropharynx and hypopharynx are rare, accounting for approximately 1% of benign laryngeal neoplasms. Spindle cell lipoma is a rarer histological variant characterised by mature adipocytes mixed with collagen-forming spindle cells. We present an unusual case of a 62-year-old lady who acutely presented to the emergency department with a large spindle cell lipoma arising from the vallecula. This lipoma was causing intermittent stridor unless traction was applied to it. Despite the size of the lesion, she had been completely asymptomatic prior to this single episode. To our knowledge, only one previous case of a spindle cell lipoma has been reported as specifically arising from the vallecula. This case also appears to be the largest reported from the oropharynx (17 cm length, 4 cm width). The tumour was completely removed endoscopically and the patient made an excellent recovery, returning home 3 days post-operatively. The histology, management and follow up of these lipomas are discussed.

Lipoma due to chronic intermittent compression as an occupational disease

A total of 15 coppersmiths who do the job as a traditional profession in Kahramanmaras Province were retrospectively analyzed for revealing a possible relationship of lipoma formation and chronic compression, as the work characteristic related to mechanical pressure to the right thoracal and shoulder region. The workers were examined and their historical data were noted. Chronic compression sites in the patients were also evaluated by magnetic resonance imaging and ultrasonography. The ages were between 30 and 52 years. Body mass index ranged from 18.6 to 38.8. Five were operated for visible lipomatous masses at their injured sites. All of the specimens were reported as containing mature adipocytes. An increased subcutaneous fat thickness at the injured sides of the patients was seen when compared with the uninjured contralateral sides using ultrasonography. At the magnetic resonance images, no capsule intensity was observed in the lipomatose masses. Subcutaneous fat of injured right mammarial regions was thicker than the other contralateral sides in all of the cases. The most prominent lipomas were seen in obese workers, and strong evidence for chronic trauma and lipoma formation as an occupational disease was obtained from the study.