Open AccessAdult cavernous haemangioma of the vocal cords with a unique presentation of acute respiratory distress: a case report
Author(s) -
A Nazemi Rafie,
Karan Jolly,
Adnan Darr,
Stuart D. Thompson
Publication year - 2020
Publication title -
annals of the royal college of surgeons of england
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.39
H-Index - 63
eISSN - 1478-7083
pISSN - 0035-8843
DOI - 10.1308/rcsann.2020.0066
Subject(s) - medicine , dysphagia , respiratory distress , presentation (obstetrics) , stridor , intubation , airway obstruction , larynx , surgery , emergency department , airway , lesion , botulinum toxin , hemangioma , psychiatry
Laryngeal haemangiomas can commonly be seen in children, and first-line treatment is usually propranolol. However, in adults, cavernous haemangioma of the vocal cord(s) is an extremely rare condition - with this being the only published adult case presenting with acute respiratory distress - the mainstay of treatment is surgical excision under microlaryngoscopy. Presentation in adults can be unpredictable, but primarily consists of hoarseness which can be associated with, dyspnoea, dysphagia, and haemoptysis - and in one documented case stenosis of the aero-digestive tract led to death. Due to these airway difficulties, surgery can often prove challenging. In this study, we explore the unusual case of a previously well 71-year-old gentleman presenting to the Emergency Department, with worsening shortness of breath as his primary complaint. Uniquely, in this case, an awake fibre-optic intubation was undertaken to manage the difficult airway and a microlaryngoscopy was performed. A 20x10x15mm lesion was excised, which had characteristics in keeping with a cavernous haemangioma on microscopic examination.