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Hemangioma of the Pyriform Sinus

In May 1998, a 77-year-old man presented to our institution with a 2-month history of a globus sensation and mild dysphagia. Endoscopic evaluation of the patient's larynx and pharynx demonstrated a greyish, nonpulsatile, polypoid tumor mass with an obvious pedicle arising from the lateral wall of the right pyriform sinus (Fig IA). The larynx was uninvolved, with normal mobility and laryngeal crepitation. With the patient under general anesthesia, this tumor mass was removed with the endoscopic CO2 laser with no active bleeding episodes or other sequelae intraoperatively. Microscopically, the tumor mass was composed of aggregates of irregular dilated blood channels and capillaries lined by flattened or prominent endothelial cells, and the vessels' luminae were tilled with blood cells. The histologic diagnosis was a mixed hemangioma with no evidence of malignancy. The patient demonstrated an excellent postoperative recovery, without any airway distress, and was discharged on the third postoperative day. Two years after surgery, there was no evidence of residual tumors or alteration of voice quality (Fig lB).