Huge retropharyngeal lipoma causing obstructive sleep apnea: a case report

Abstract

Lipoma of the retropharyngeal space is a very rare benign tumor often causing unspecific clinical symptoms. The most common symptoms are dysphagia and/or respiratory disturbances. The clinical diagnosis may be difficult. The radiological imaging techniques (CT and MRI) can provide adequate information with regard to the composition and extension of the tumor, although final histological confirmation is essential. Surgery is the treatment of choice. We present a case of 40-year-old male patient complaining of obstructive sleep apnea symptoms (respiratory disturbances, excessive daytime somnolence, morning headache). The radiological examination (CT) showed a huge (11.7 x 7.2 cm) lipoma of the retropharyngeal space extending from the nasopharynx to the superior mediastinum. The tumor was removed via transcervical approach with complete amelioration of symptoms.

A huge retropharyngeal lipoma causing obstructive sleep apnea

“…Although there are many surgical approaches in treatment of retropharyngeal lipomas, the best surgical field of view can be obtained by a transcervical approach, which is preferred for huge retropharyngeal lipomas. [6] As in our case, this approach enables a larger field of view and total excision of the mass.…”

“…The most common symptoms are wheezing, dyspnea, dysphagia and snoring as in our case. [4,6,7] The mass should reach quite huge dimensions to cause OSA as previously reported in a few cases. [1,6] In our case, the OSA symptoms which were present for a long time were investigated with preoperative PSG and severe OSA (AHI: 75) was determined.…”

“…Although some cases reported in the literature were followed up since the patient denied surgery, the definitive treatment of retropharyngeal lipomas is surgery. [1,5,6,11] The treatment of large or deeply located symptomatic lipomas is classically total excision with its capsule. Although there are many surgical approaches in treatment of retropharyngeal lipomas, the best surgical field of view can be obtained by a transcervical approach, which is preferred for huge retropharyngeal lipomas.…”

Giant Retropharyngeal Lipoma

“…Retropharyngeal lipoma case is not clearly described in the literature study, as shown in Table 1 that since 1877 until now, not more than 46 cases are reported, including this case. symptoms, depending on the affected part of aero digestive tract, such as nasal obstruction, tightness, hoarseness, snoring, and a sense of prop when swallowing food, depend on the location and size of the tumor [3,6,[10][11][12][13]. The patient had early symptoms of nasal obstruction during sleeping on right side and prop sense when swallowing, followed by longer process of swallowing, snoring, hoarseness, and dyspnea while sleeping.…”

Prevalence of obstructive sleep apnea in patients with squamous cell carcinoma of the tongue following ablation surgery

“…Overnight polysomnography (PSG) was used to determine the apneaehypopnea index (AHI Factors that increase the vulnerability of OSA include age, gender, obesity, family history, menopause, craniofacial abnormalities, and certain health behaviors such as cigarette smoking and alcohol abuse. 1,3 Although craniofacial abnormalities have an effect on patients with OSA, these significantly vary among patients with (1) enlarged soft tissues such as the tongue base and palate, 4,5 (2) narrowing of the pharyngeal space due to anatomic abnormalities, 6,7 and (3) loss of function of the pharyngeal space due to anatomic abnormalities. 8 Thus, patients who were successfully treated for head and neck cancers often have a partially obstructed upper airway, which is functional during the day but collapses during sleep.…”