Fibromuscular hamartoma of the esophagus in an infant

An 11-month-old infant had a history of dysphagia and continuous drooling without evidence for airway obstruction. A biopsy specimen of a neck mass on the left side adherent to the larynx and esophagus demonstrated pathologic features characteristic of a fibromuscular hamartoma. Upper airway obstruction subsequently ensued and the patient was managed for 16 months with a tracheostomy and feeding gastrostomy. Although posing an extremely difficult management problem, this benign tumor was surgically removed without damage to the larynx when the patient was 28 months old. The differential diagnosis of this unusual lesion must consider congenital fibromatosis and fetal rhabdomyoma.