Large Vallecula Epiglottica Lipoma: A Rare but Fatal Cause of Dysphagia

Lipoma is a benign mesenchymal tumor with 13% occurrence in the head and neck region. Despite being the commonest type of tumor, it only accounts for 0.6% of the upper aerodigestive tract. We report a case of a 41-year-old gentleman who presented with progressively worsening dysphagia and a muffled voice. A flexible nasopharyngeal endoscope showed a solitary well-lobulated pedunculated cystic-looking mass occupying the oropharynx arising from the vallecular space and lingual surface of the epiglottis with a partially seen mobile posterior vocal cord. CT of the neck showed a single lesion with fat attenuation in the right vallecula and right lateral lingual epiglottis. The patient underwent endoscopic surgical excision and fully recovered post-operatively. Although rare, lipoma must be considered one of the differential diagnoses of midline laryngeal mass. Therefore, prompt excision needs to be performed to prevent a catastrophic outcome.