case_images: PMC11796487_01
case_images: Laryngoscopic visualization of the tumor. Image of fibrolaryngoscopy that shows a submucous, smooth, circumferential tumor in the hypopharynx (asterisk), dependent on the right pharyngeal wall, which obstructs the visual field (yellow arrow: left arytenoid; white dotted arrow: left aryepiglottic fold; arrowhead: left pyriform sinus).
case_images: cureus-0017-00000076998-i01.jpg
case_images: PMC11796487_01_cureus-0017-00000076998-i01.jpg
case_images: FIG1
case_images: Indirect laryngoscopy was performed, showing an exophytic, pinkish, regular, circumferential supraglottic lesion, which obstructed the hypopharynx (Figure 1).
case_images: Contrast CT scan. Computed tomography in transversal (A), coronal (B), and sagittal (C) views, performed at the time of diagnosis, demonstrates a low-density lesion with an apparent origin in the paraglotic space, which crosses the midline and extends to the oropharynx, obstructing the upper aerodigestive tract (asterisk).
case_images: cureus-0017-00000076998-i02.jpg
case_images: PMC11796487_01_cureus-0017-00000076998-i02.jpg
case_images: FIG2
case_images: Given upper airway obstruction, the patient was admitted to the emergency department, where venous blood gas parameters and computed tomography (CT) were conducted (Figure 2).
case_images: Intraoperative oral examination. Intraoperative oral examination revealed tumor adhesion fibers to the right tonsil. Laryngosuspension and microscopic surgery were attempted, but due to aerodigestive obstruction, they were abandoned.
case_images: cureus-0017-00000076998-i03.jpg
case_images: PMC11796487_01_cureus-0017-00000076998-i03.jpg
case_images: FIG3
case_images: During the preoperative assessment, an increase in the volume of the tumor was identified; the lesion was now visible through the oropharynx, in contact with the hard palate, and showed adhesion fibers with the right tonsil (Figure 3).
case_images: Surgical approach and specimen. A-C: External surgical approach with an almost immediate demonstration of tumor herniation; D: Surgical specimen
case_images: cureus-0017-00000076998-i04.jpg
case_images: PMC11796487_01_cureus-0017-00000076998-i04.jpg
case_images: FIG4
case_images: A fibrous stalk-shaped origin of the lesion was identified on the anterior pharyngeal wall (Figures 4A-4C). The final histopathological examination revealed a 140 g nodular tumor, measuring 5 x 4.5 x 4.5 cm, covered by a smooth and translucent capsule (Figure 4D).
case_images: Histopathological characteristics of the surgical specimen. A: Macroscopic image of the specimen, which weighed 140 g and measured 5 cm at its largest dimension. It was lobulated and yellowish in color. A small fragment of mucosa was observed (arrow); B: The mucosal fragment showed a proliferation of capillary vessels in the lamina propria and a mild chronic inflammatory infiltrate (H&E, 5X); C: he specimen was composed of mature adipose tissue (H&E, 10X); D: Certain areas of the tissue displayed prominent fibrosis (H&E, 5X).
case_images: cureus-0017-00000076998-i05.jpg
case_images: PMC11796487_01_cureus-0017-00000076998-i05.jpg
case_images: FIG5