A Rare Case of Laryngeal Schwannoma in a Young Woman: An Interventional Aid

Purpose: A 24-year-old woman patient presented with noisy breathing for 7 years and change in voice for 3 years. On local examination, there was a growth in the right aryepiglottic fold, right arytenoid cartilage. The right vocal cord was not seen. Pooling of saliva was seen in the right pyriform fossa.

Materials and Methods: Magnetic resonance imaging (MRI) was done using Siemens Skyra 3 Tesla MRI Scanner. The interventional procedure was done in the cath lab using a GE Innova 41001Q machine.

Results: MRI of the neck showed a well-defined, intensely enhancing lesion involving the hypopharynx and right aryepiglottic fold and extending up to the right vocal cord. The patient was planned for preoperative embolization to minimize intraoperative blood loss. Using a 4-Fr headhunter catheter, the right external carotid artery was accessed, and angiography showed an area of contrast blush in the subglottic region. The right ascending pharyngeal artery was superselectively catheterized with a 2.4-Fr microcatheter, and angiography showed an area of contrast blush, which was subsequently embolized with 150- to 250-micron-sized polyvinyl alcohol particles. Postembolization angiography showed a significant reduction in flow to the lesion. The next day, the patient underwent transoral robotic excision of the lesion without any complications. Histopathologic diagnosis of the excised lesion came as laryngeal schwannoma.

Conclusions: Laryngeal schwannomas are rare, benign neurogenic tumors. They are slow-growing, encapsulated, submucosal lesions in the larynx. The aryepiglottic fold is the most common anatomic site. Preoperative embolization is a valuable adjunct to surgical resection.