Lipoma of Piriform Sinus: A Case Report and Review of the Literature

Abstract

The lipomas of oropharynx, hypopharynx, and larynx are so rare that up to now approximately there have been 100 cases reported. The lipomas are slow-growing lesions that are capable of reaching considerable dimensions and are often detected at a late stage. The symptoms can vary both in dimension and in location, semiobstructing the aerodigestive tract or exerting compression on adjacent structure. In this case, the lesion, which originated from the piriform sinus, was removed endoscopically urgently due to obvious signs of tissue suffering caused by stretching of the pedicle as a result of displacement of the mass. The two aims of this case report are to expose an interesting and rare case study mainly for an Emergency Room Specialist and an ENT (Ear, Nose, and Throat) Specialist involved in solving the problem and to demonstrate that the choice of an endoscopic approach is useful in order to have an optimal visualization of the lesion and to perform a total eradication. The use of endoscopic devices also allows a rapid postoperative recovery, compared to external access and optimum locoregional control in the follow-up procedures to prevent possible relapses.

A case of hypoharyngeal lipoma with extrapharyngeal extension

“…In elongated polypoid lesions, the patient may present with lipoma protruding through the mouth, which is usually preceded by a coughing episode. 2,3 The patient with pedicled lipoma may also experience episodes of breathing difficulties due to occasional lipoma prolapse in the laryngeal inlet. 2 Death due to asphyxia has also been described.…”

An extremely rare pedunculated lipoma of the hypopharynx: A case report

“…Lipoma in the pharynx is relatively rare[3], and accounts for 0.6% of the benign tumors of the pharynx[4]. Lipoma is associated with endocrine factors, infection, chronic disease, infection, and heredity[5]. Lipoma of the hypopharynx grows slowly and generally has no obvious symptoms.…”

“…Some authors recommend endoscopic resection for small lesions, while for tumors larger than 2 cm, open surgery is preferred[7]. Others suggest that endoscopic surgery has advantages of quick recovery and less trauma to patients, and endoscopic resection may also be used for larger masses[5,8]. In contrast to previous reports of similar cases, we used the plasma knife as the resection tool.…”

Lipoma of right pyriform sinus

“…Endoscopic appearance of laryngeal and hypopharyngeal lipomas can vary from a submucosal mass to a pedunculated polyp 6. They are encapsulated with a smooth surface and covered by a yellowish-pink mucosa,15 for that they can frequently confused with other benign lesions such as mucous retention cyst or laryngocele 5 6 16. However, lipoma could be easily distinguished from these lesions using imaging techniques such as CT scan and MRI.…”