Flexible Laryngoscopic Examination Demonstrating Significant Airway Obstruction by the Pedicle of the Mass

Flexible laryngoscopy examination of a man in his 70s who presented to the hospital after expelling a bilobed mass from his mouth during a violent episode of nausea and vomiting. Computed tomographic scan of the neck with contrast demonstrated a 30-cm mass pedicled from the hypopharynx. After presentation to the hospital, the patient became progressively more dyspneic, dysarthric, and unable to swallow his own secretions. Flexible laryngoscopy demonstrated significant airway obstruction caused by the edematous pedicle of the mass; the right vocal fold can only be intermittently visualized on inspiration. The patient was taken to the operating room for an awake tracheostomy, and the mass was subsequently resected via transoral approach. Pathology demonstrated a well-differentiated esophageal liposarcoma, previously known as a giant fibrovascular polyp of the esophagus. Click the Related Article link for full details.