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Postcricoid hemangioma of childhood: report of four cases
Ramez J Awwad1, Anthony J Mortelliti
1Department of Otolaryngology and Communication Sciences, State University of New York Upstate Medical University, Syracuse, New York 13210, USA.
Insights
Postcricoid hemangiomas, rare infantile tumors in the hypopharynx, may be more common than previously thought. These lesions can be asymptomatic incidental findings, with this study detailing the longest follow-up of such a case.
Area of Science:
- Pediatric Otolaryngology
- Pediatric Oncology
- Head and Neck Surgery
Background:
- Infantile hemangiomas are common pediatric tumors, predominantly affecting the head and neck.
- Laryngeal hemangiomas typically occur in the subglottis; postcricoid hypopharyngeal locations are rare.
Observation:
- This study presents four cases of hemangiomas in the postcricoid region of the hypopharynx.
- Lesions can enlarge with crying/straining, aiding diagnosis via laryngoscopy.
- Under anesthesia, lesions may appear smaller or unnoticed, potentially leading to underdiagnosis.
Findings:
- Unlike typical presentations, these postcricoid hemangiomas were asymptomatic incidental findings.
- The study reports the longest follow-up (6 years) for a postcricoid hemangioma.
- This is the first description of the natural course of a postcricoid hemangioma.
Implications:
- The true incidence of postcricoid hemangiomas may be underestimated.
- Awareness of asymptomatic postcricoid hemangiomas is crucial for accurate diagnosis.
- Understanding the natural history informs clinical management and surveillance strategies.
Abstract:
Hemangiomas are the most common tumor of infancy, and the vast majority occur in the head and neck region. In children, laryngeal hemangiomas typically occur below the level of the true vocal folds, in the region of the subglottis, and other sites are exceedingly rare. We present four cases of hemangiomas located in the postcricoid region of the hypopharynx. Because of the location of these lesions, children may present with obstructive symptoms such as dysphagia, intermittent aspiration, hypersalivation, or recurrent respiratory infections. Clinical diagnosis is relatively easily made with flexible laryngoscopy, as the lesions have a propensity to enlarge with crying or straining. When these patients are examined under general anesthesia in a relaxed state, however, the lesions are typically much smaller, and can even go unnoticed. Unlike other reported cases, the postcricoid hemangiomas in our patients were not causing any symptoms and were simply incidental findings. Thus, we believe that the true incidence of postcricoid hemangiomas is likely higher than reports suggest. To our knowledge, we report the longest follow-up (6 years) of a patient with a postcricoid hemangioma and are the first to describe the natural course of such a lesion.
