A retropharyngeal lipoma causing obstructive sleep apnea in a child

Lipomas are common benign tumors, but they rarely occur in the retropharyngeal space and even more rarely occur in children.

We report the case of an 11-year-old girl with a 5-year history of progressively worsening nasal obstruction, snoring, and excessive daytime sleepiness. Physical examination revealed a child with a body mass index of 16.9 kg/m2; otolaryngologic examination and imaging studies showed a large retropharyngeal mass. Polysomnography indicated an apnea-hypopnea index of 13.9 events per hour of sleep and a minimum oxygen saturation of 84%, with 20 episodes of desaturation to less than 90%. After complete excision of the mass, the patient's snoring, apnea, and daytime sleepiness resolved.

Although lipomas in the retropharyngeal space are rare, clinicians should be alert to the possibility of this condition occurring in children who have symptoms of obstructed breathing during sleep but a normal body mass index and no other risk factors for obstructive sleep apnea.