Large epidermal cyst of the larynx: A case report

Epidermal cysts are benign cysts filled with keratin masses that can develop anywhere in the body and tend to grow slowly. Histologically they are similar to cholesteatoma. Epidermal cysts of the larynx are an extremely rare disease and it is not possible to estimate their occurrence. The most common localization in the larynx is in vestibular folds, however, there are publications on their localizations in vocal folds. Aim. To present data on an epidermal cyst of the larynx and long-term results of microendolaryngeal surgical treatment, using a case report. Materials and Methods. Patient P. (71 y. o., F) was admitted to the Rostov Regional Clinical Hospital with signs of the stage 1 laryngeal stenosis and dysphonia. During examination, the patient was found to have a neoplasm of the hypopharynx and vestibular part of the larynx, covered with an unchanged mucous membrane, narrowing the lumen of the larynx by more than half and preventing examination of her vocal folds. According to magnetic resonance imaging, it was a cyst of the left vestibular fold measuring 30.5 x 35 x 32 mm, adjacent to the left half of the epiglottis and the left vocal fold. Results and Discussion. Due to the submucosal location of the tumor, a biopsy of the tumor was performed using direct microlaryngoscopy in the high-frequency jet ventilation conditions through tracheopuncture with urgent histological examination and determination of further tactics based on the findings. Taking into account the results of an urgent histological examination, the cyst was removed endolaryngeally. The patient was under medical supervision at the Rostov Regional Clinical Hospital during 3 years after treatment with no signs of cyst recurrence. As a result of treatment, complete restoration of vocal and respiratory function was achieved. Conclusions. Microendolaryngeal surgical treatment in the high-frequency jet ventilation conditions through tracheopuncture allows organ-preserving treatment without tracheostomy for patients with voluminous cystic neoplasms of the larynx.