Epiglottic masses identified on CT imaging: A case report and review of the broad differential diagnosis

Abstract

Epiglottic masses may be cystic, granulomatous, infectious, benign or malignant neoplastic, or manifestations of a systemic disease. When large in size, the airway may become obstructed, and when accompanied by suspicious features such as cartilaginous invasion, extension to the pre-epiglottic or para-glottic spaces, or lymphadenopathy, the radiologist must consider malignancy as a primary differential diagnosis. However, when only benign features are identified, the differential diagnosis is broad. We present a 65-year-old female with an incidental 1 cm exophytic, pedunculated, papillomatous lesion on the laryngeal surface of the epiglottis discovered upon endoscopic evaluation for dyspepsia and heartburn. Because of her risk factors for malignancy, CT scan was requested and revealed only benign features. Subsequent excisional biopsy revealed a benign squamous papilloma; however, multiple additional differential considerations were entertained preoperatively.

Large Vallecular Masses; Differential Diagnosis and Imaging Features

“…Similarly, wide range of rare granulomatous, infectious, and neoplastic conditions of epiglottis can manifest as vallecular mass lesions. [ 1 2 7 ]…”

“…Other similar infrequent types of malignant vallecular mass lesions described in the literature include clear cell carcinoma and myoepithelial carcinoma of minor salivary glands. [ 2 ] The MR imaging features were diagnostic which accurately revealed the extent of disease. The typical imaging feature of various vallecular masses is described in Table 2 .…”

“…The other causes include a group of very rare low-grade malignant lesions of minor salivary glands, uncommon benign developmental vascular anomalies, lipomas, dermoid, and epidermoid. [ 1 2 ] These patients can remain asymptomatic or rarely manifest with serious acute airway obstruction. Computed tomography (CT) and magnetic resonance imaging (MRI) are the main imaging modalities to characterize these lesions, to establish the origin of the tumor, and to delineate the extent of disease.…”

Mantle Cell Lymphoma: A Rare Vallecular Tumour

“…The commonest vallecular mass is benign retention cyst 2 . Other rare causes include lingual thyroid cyst, thyroglossal cyst, minor salivary gland tumours, lipoma, schwannoma, lymphangioma, haemangioma, granulomatous or infectious diseases, malignant conditions including squamous cell carcinoma, or very rarely lymphoma 3 . Large vallecular tumour often has challenging airway as it often displaces epiglottis posteriorly causing airway obstruction.…”

Użyteczność badania 18F-FDG PET/CT w diagnostyce raka krtani

“…Wśród objawów rozwijającego się raka krtani wyróżniamy m.in. : chrypkę lub bezgłos, duszności, a z czasem -niedokrwistość [3]. W zależności od stopnia zaawansowania choroby, terapia obejmuje przezustną mikrochirurgię laserową, częściową lub całkowitą laryngektomię, a także leczenie chirurgiczne skojarzone z radiochemioterapią [4].…”