Abstract
A case of giant hemangioma that extended from the anterior cervical region to the superior mediastinum, with a major axis of 16 cm, is reported.
A 48-year-old female who suffered hoarseness had been diagnosed with hemangioma at another hospital 10 years ago. Recently, she complained of dyspnea caused by a laryngeal lesion during vocalization and was referred to our hospital.
Fiberoptic examination showed a pedunculated tumor with its pedicle on the left arytenoid. The tumor fitted into the supraglottic cavity to induce dyspnea on inhalation during vocalization. MRI examination showed the existence of a giant hemangioma occupying the cervical region to the superior mediastinum reaching to the level of the third thoracic vertebra.
Resection of the pedunculated tumor together with tracheostomy was planned for airway management. However, we confronted unexpected bleeding from the tumor occupying the frontal neck, and the tracheostomy procedure could not be completed, necessitating a second surgical attempt at tumor removal. In the second surgery, the pedunculated tumor was successfully removed by lateral pharyngotomy using peroral intubation modality for postoperative airway management.
Our experience suggests the importance of proper planning of airway management modality for safe and successful surgery on a patient with a large tumor in the trachea.
