A 2-month-old infant was referred by her pediatrician due to poor gain since birth.
Among her personal history, she was the product of a controlled pregnancy of 40 weeks duration, without pathologies or treatments of interest.
She was born by cesarean section and weighed 3650 g (adequate weight), with no perinatal complications.
His mother had noticed a thick mucous rhinorrhea since, which increased in the last weeks and made it difficult for him (70 mL every 4 h), initially consulting a non-target pediatrician due to a non-target managed feeding episode.
At the time of admission to our service he weighed 4150 g (< percentile 3).
He had a malnourished appearance with pale skin and his breathing with open mouth and his neck hyperextended and lateralized to the right stood out.
He did not present tachycardia, tachypnea, fever or stridor, and 100% coughed while breathing room air.
Their length (59.5 cm) and perimeter (41 cm) were adequate (75 percentile).
Blood count, biochemistry, chest X-ray, sweat test, ferrokinetic study and immunological tests were normal.
Contrast enhanced MRI showed a well-defined mass occupying the lumen of the hypopharynx and posteriorly displacing the larynx without reaching colapse.
The contrast flowed into the nasopharynx and entered the bronchial tree, suggesting aspirations when swallowing.
After this finding, a consultation with the otorhinolaryngologist was carried out, who performed a flexible nasofibroscopy and confirmed the cystic tumor originating from the valecular region that pushed the epiglotis against the posterior laryngeal wall.
The patient was taken to the operating room for direct laryngoscopy and removal of the lesion. Intubation was difficult and required transoral fibro-endorsement to complete it, given that the hypopharynx cyst was almost 60% of the total.
Laryngomalacia or other structural or anatomical alterations of the airway were not observed.
A clear mucoid secretion was aspirated from the cyst and marsupialization was performed with partial resection of the cystic wall by scissors.
Histological examination of the specimen showed a respiratory epithelium with squamous metaplasia, as well as connective tissue without inflammatory cell infiltration.
She was discharged 3 days after surgery.
At the outpatient clinic, at 2 months, there was no recurrence of the lesion on nasofibroscopy.
After 4 months, the patient had improved caloric intake and showed good weight gain.
