Retropharyngeal Lipoma: a case report

Introduction: Retropharyngeal lipoma is a rare benign tumor (less than 27 reports in literature) of nonspecific clinical symptoms. It can grow to an enormous extent causing total obstruction of the upper respiratory tract. Until now its etiology is unknown. Case Report: A 60-year old female complained from severe snoring mild dysphagia and moderate respiratory difficulty with gradual onset since one year prior to clinical presentation. In Oropharyngeal examination and indirect laryngoscopy there was a bulging over posterior pharyngeal wall extending from the level of soft palate to lower part of hypopharynx with moderate closure of laryngeal inlet and soft consistency on palpation. Fine needle aspiration was in favour of neurofibroma but CT scan and MRI showed criteria of a large retropharyngeal lipoma (75×50 mmoval shaped). The mass was removed completely via transpharyngeal approach with creation of U- shaped flap. Post operative pathologic study confirmed the diagnosis of lipoma. Conclusion: Lipoma as differential diagnosis of retropharyngeal tumors always has to be considered. Surgical intervention through pharyngeal or cervical root is recommended. To prevent functional complications resulting from tumor and surgery and to get information about the extent of the lipoma accurate radiological imaging is mandatory.