Persistent Oropharyngeal Hemangioma Causing Progressive Upper Airway Compromise: Diagnostic and Therapeutic Challenges.
This case report describes a 15-year-old girl with a longstanding, hypervascular oropharyngeal lesion causing partial airway obstruction whose respiratory symptoms resolved with apparent clinical improvement after six months of oral propranolol.
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This case report describes a 15-year-old girl with a longstanding, hypervascular oropharyngeal lesion causing partial airway obstruction whose respiratory symptoms resolved with apparent clinical improvement after six months of oral propranolol.
Research significance
The reported observation supports only that propranolol coincided with symptomatic and apparent clinical improvement in this patient; it suggests, but does not establish, that propranolol could be a nonsurgical treatment for selected obstructive oropharyngeal hemangiomas in adolescents.
Source abstract
Hemangiomas are rare benign vascular tumors of the oral cavity. Lesions involving the soft palate and oropharynx may cause significant functional impairment and, in advanced cases, life-threatening upper airway compromise. We report the case of a 15-year-old girl with a longstanding palatal mass first identified in early childhood who presented with progressive enlargement of the lesion, accompanied by dyspnea, odynophagia, and globus sensation. Physical examination and flexible nasolaryngoscopy revealed an extensive violaceous vascular lesion causing partial upper airway obstruction. Contrast-enhanced computed tomography (CT) and CT angiography demonstrated a hypervascular lesion consistent with a probable clinicoradiologic diagnosis of hemangioma, without evidence of osseous involvement. Given the lesion's extensive size and anatomically challenging location, surgical resection was deemed unsuitable, and oral propranolol was initiated following multidisciplinary evaluation. During six months of clinical follow-up, the patient demonstrated resolution of respiratory symptoms, no treatment-related adverse effects, and apparent clinical improvement. This case highlights the importance of a comprehensive diagnostic evaluation and individualized multidisciplinary management for complex vascular lesions involving the upper airway.