Large Vallecular Masses; Differential Diagnosis and Imaging Features

Abstract

Large vallecular masses are an uncommon disease entity which includes a wide spectrum of rare pathologies. These masses may present as purely vallecular in location or appear as an extension from adjacent anatomical sites like tongue base including lingual tonsils, epiglottis, palatine tonsils, epiglottis, and the remainder of supraglottis. Literature review reveals very rare conditions presenting as vallecular mass lesions. The imaging features are generally diagnostic for characterization. However, these masses can exhibit indeterminate appearance at imaging. We present a series of five cases which includes two rare presentations: a case of low-grade cribriform adenocarcinoma of the base of tongue and a vallecular lipoma. The other three cases presented for differential diagnosis including benign vallecular cysts and two cases to show that malignant masses arising from neighboring anatomical sites such as tongue base or supraglottic larynx can exhibit significant vallecular component.

Oropharyngeal lipoma; a rare and dangerous cause of voice change

“…On CT, they appear as well defined, non-enhancing, low attenuation (65–125 Hounsfield Units) homogenous lesions, as demonstrated in this case 4 5. The differential diagnoses of vallecular lesions include malignant tumours, benign vallecular cysts such as mucous retention cysts and dermoid or epidermoid cysts 5. A lipoma located in a different area of the upper aerodigestive tract, such as the larynx, should also be considered as a differential diagnosis for clinical presentations such as that described in this case 6…”

“…Oropharyngeal lipomas have typical characteristics on CT and MRI and therefore imaging of these lesions is important for diagnosis but also for anaesthetic and surgical planning. On CT, they appear as well defined, non-enhancing, low attenuation (65–125 Hounsfield Units) homogenous lesions, as demonstrated in this case 4 5. The differential diagnoses of vallecular lesions include malignant tumours, benign vallecular cysts such as mucous retention cysts and dermoid or epidermoid cysts 5.…”

Mantle Cell Lymphoma: A Rare Vallecular Tumour

“…It contains mainly glandular or lymphoid tissues. Its tumour is not among common disease entities 1 . The commonest vallecular mass is benign retention cyst 2 .…”

Laryngoscopy-assisted fiberoptic intubation in an adult with a large vallecular haemangioma

“…Vallecular masses mostly present as cystic lesions in infants and children. [ 2 ] Airway management strategies change based on the location. Cystic lesions have been managed by authors by aspiration.…”