Necrobiotic xanthogranuloma of larynx – an extremely rare case report

Necrobiotic xanthogranuloma (NXG) is a rare non-Langerhans cell histiocytosis with exceptionally uncommon laryngeal involvement. We report a 45-year-old male presenting with hoarseness and airway obstruction due to a supraglottic mass. Surgical excision via microlaryngoscopy was complicated by recurrent bleeding, which was ultimately managed with superior thyroid artery ligation. Histopathological evaluation confirmed NXG, showing necrobiosis, giant cells, cholesterol clefts, and CD138 positivity. The patient recovered uneventfully, with symptom resolution and a patent airway at follow-up. This case emphasizes the need to consider NXG in the differential diagnosis of laryngeal masses and highlights the importance of multidisciplinary evaluation and surgical preparedness for hemorrhagic complications.