Background
Chondroid lipomas are extremely rare benign adipocytic neoplasms comprising embryological fat and cartilage tissue.1,2 The larynx remains a rare site and is yet to be reported in the literature.
A 60-year-old male presents with a 6-month history of progressive dysphagia, dysphonia and difficulty lying flat. His past medical history includes anxiety, depression, and post-traumatic stress disorder. His symptoms were attributed to anxiety following a normal gastroscopy performed in the community. Physical examination shows a thin male with a soft inspiratory stridor. Flexible nasendoscopy (FNE) demonstrated a well-circumscribed, mobile 3x3cm mass from the lingual surface of the left epiglottis obscures the glottis. Computed tomography (CT) revealed a well-circumscribed (29mm x 26 mm) mass extending from the epiglottis with no invasion of the lesion with surrounding structures.
An awake fibre optic intubation was performed under remifentanil and midazolam. He was intubated with a right nasal size 7 ETT, and we performed a microlaryngoscopy and biopsy. Findings were consistent with the FNE; glottis and subglottis were tumour-free. The mass was excised via cold steel. Histology revealed a chondroid lipoma, completely excised. The patient was discharged home on day two post-op, with no evidence of recurrence at six-month follow-up.
This is the first laryngeal chondroid lipoma reported in the literature. Our patient presented with an inspiratory stridor and a threatened airway when lying flat. His airway was secured via awake fibreoptic intubation. The diagnosis of a chondroid lipoma is imperative, as it can often be misdiagnosed as a sarcoma. As such, its recognition is crucial, as complete excision in the case of a chondroid lipoma is curative.2