Congenital lobular capillary hemangioma of the larynx: A case report

Objective To report a rare occurrence of a congenital lobular capillary hemangioma, also known as a pyogenic granuloma, of the neonatal larynx. Secondarily, this manuscript serves as an overview of the differential diagnosis of the laryngeal causes of upper airway obstruction. Study design Case report and comprehensive literature review. Methods A retrospective case review of a pediatric patient presenting with a congenital lobular capillary hemangioma. Comprehensive literature review was completed over viewing the complex differential diagnosis and management principles. A stepwise evaluation technique is described for patient work-up. Setting A tertiary care pediatric hospital. Result The primary objective of this investigation is to review the history of a neonate who presented at birth with stridor. The diagnosis was discovered to be a congenital lobular capillary hemangioma of the larynx, in as much as there was no prior history of airway manipulation, endotracheal intubation, or any other form of local laryngeal trauma. Conclusion It is important to consider the diagnosis of a congenital lobular capillary hemangioma of the larynx when evaluating the stridorous neonate with no prior history of airway manipulation. Lobular capillary hemangiomas are commonly mistaken to be synonymous with reactive granulomas. Whereas the clinical appearance and inciting events in these conditions are comparable, their histopathology is quite different. The lobular capillary hemangioma has diagnostic, lobular arrangement of capillaries at its base with associated stromal edema; superficial ulceration is also a common feature. To the best of our knowledge, only one publication has previously described a similar finding.