gms | German Medical Science

81. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

12.05. - 16.05.2010, Wiesbaden

Acute distress in adults – case report of an endolaryngeal lymphangioma

Meeting Abstract

Suche in Medline nach

  • corresponding author presenting/speaker Peggy Lange - Otorhinolaryngology, University Giessen, Germany
  • Frank Driever - Pathology, University Giessen, Germany
  • Christoph Arens - Otorhinolaryngology, University Madgeburg, Germany
  • Jens Peter Klußmann - Otorhinolaryngology, University Giessen, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 81st Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Wiesbaden, 12.-16.05.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. Doc10hno007

doi: 10.3205/10hno007, urn:nbn:de:0183-10hno0072

Veröffentlicht: 6. Juli 2010

© 2010 Lange et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen ( Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.



Lymphangiomas are rare congenital malformations of the lymphatic system. Over 90% of patients present in clinic with isolated swellings in the head and neck area in early childhood. In contrast endolaryngeal lymphangiomas in adult coming up with acute distress are a rarity in otorhinolaryngology. On the basis of a clinical case we discuss symptoms, diagnostics, acute airway management and therapy strategies of this disease.

The 26-year old patient presenting in the emergency service with acute dyspnea complained about inspiratory stridor since 2 weeks and an altered speech since the day before. Past medical history revealed an occasional asthma and a nicotine abuse of 5 pack years. During examination the increasingly somnolent patient showed loud breathing noises. Laryngoscopy revealed an exophytic tumor of the right aryepiglottic region with nearly complete obstruction of the endolaryngeal lumen.

Immediate monitoring of the patient, application of cortisone and inhalation of sympathomimetics were started. After fiberoptic guided intubation we performed a laser surgical debulking of the tumor. The histopathological processing revealed a lymphangioma.

We agreed with the patient in frequent follow-up with possible tumor debulking in the case of growth progression. To decrease recurrency rate complete excision would be necessary, which is often not practicable in particular in the endolaryngeal region. Sclerotherapy (for example Picibanil) could be an alternative treatment. Picibanil is a product of Streptococcus A. Injected in the cystic lesions of the lymphangioma it induces an inflammatory reaction leading to agglutination of the cystic parts of the lymphangioma. A high recurrency rate of nearly 100% is described in literature after this treatment. After incomplete excision of lymphangioma a recurrency rate of 40% and after complete resection a recurrency rate of 17% is described.

In conclusion a conservative laser surgical debulking of endolaryngeal lymphangioma with frequent follow-up in adults is an adequate therapy for this rare disease.


Hartl DM, Roger G, Denoyelle F, Nicollas R, Triglia JM, Garabedian EN. Extensive lymphangioma presenting with upper airway obstruction. Arch Otolaryngol Head Neck Surg. 2000 Nov;126(11):1378-82.
Kenton A, Duncan N, Bhakta K, Fernandes CJ. Laryngeal lymphatic malformation in a newborn. J Perinatol. 2003;23(7):567-71. DOI: 10.1038/ Externer Link
Seven H, Topuz E, Turgut S. Isolated laryngeal lymphangioma showing the symptoms of acute epiglottitis. Eur Arch Otorhinolaryngol. 2004;261(10):548-50. DOI: 10.1007/s00405-002-0486-6 Externer Link
Vaishali B, Nambiar A, Indudharan R. Lymphangioma of the larynx. J Laryngol Otol. 2007;121(4):e2. DOI: 10.1017/S0022215107005695 Externer Link