[Lipoma of the hypopharynx: role of computerized tomography in the diagnosis protocol]

A case of hypopharyngeal lipoma is reported and the fundamental role of C.T. in the diagnosis of laryngo-pharyngeal neoplastic pathologies is emphasized. Laryngoscopy made it quite easy to detect the lesion, showing the smooth surface of a large tumor, although it proved difficult to explore the lower portion because of the narrowing of the larynx. Thermography showed a hypothermia area in the right neck region but did not offer any further information. Only C.T. made correct identification of the site and extension of the lesion possible. It was also possible to identify its fat composition, as suggested by the typical density pattern. The tumor presented a homogeneous hypodense structure and its limits were well defined throughout their entire extension. Furthermore, it was possible to rule out any macroscopic infiltration of the adjacent cartilaginous surfaces of the larynx. The latter feature was confirmed by the C.T. images obtained after intravenous administration of an iodine contrast medium and was consistent with the hypothesis of a benign lesion. Thus the lesion could be considered a lipoma; a highly uncommon non-epithelial tumor of the hypopharyngeal region but which occurs more frequently than liposarcoma. Nonetheless, such C.T. tissue characterization requires histological support so as to prevent distinguishing a well differentiated liposarcoma only after recurrence. The greatest likelihood for accurate diagnosis lies in complete utilization of the data derived from the entire diagnostic procedure. The direct laryngoscopy of the lesion is very important as it makes it possible to inspect the surface and first evaluate any anatomo-pathological alterations. Nonetheless, the most extensive information is provided by C.T.(ABSTRACT TRUNCATED AT 250 WORDS)