Acute Laryngeal Dyspnea as the First Presentation of Mantle Cell Lymphoma: A Case Report and Review of the Literature

Introduction. Acute laryngeal dyspnea is a life-threatening emergency, and the causes in adults are most often laryngeal tumors or inflammatory edema. Lymphoma of the larynx and especially the mantle cell type is extremely rare. Case Presentation. We report a case of a 43-year-old woman with no particular pathological history. She presented with progressive dyspnea which has evolved towards an inspiratory bradypnea that worsened until she ultimately required an emergency tracheotomy. Biopsies revealed mantle cell lymphoma. The patient has been staged IVB MIPI 6, and she was treated by immunochemotherapy followed by ASCT. The therapeutic evaluation shows a complete remission, 18 months after, and the patient was always disease free. Conclusion. The laryngeal localization of the mantle cell lymphoma is extremely rare; it may present catastrophically with acute airway obstruction. The diagnosis is mostly histological, hence the interest of deep biopsy. Given its rarity, the therapeutic strategy must be discussed case by case in a multidisciplinary consultation meeting.

Unusual cause of laryngeal dyspnea and swallowing troubles in a 2-year old child

Plexiform neurofibromas are rare benign tumors developed from peripheral nervous system often associated with neurofibromatosis type 1. We report the case of multifocal plexiform neurofibromas in a 2-year-old child with cervical mass obstructing the trachea causing respiratory distress. A cervical ultrasound examination was performed followed by enhanced CT and MRI. Imaging revealed an expansive cervical mass extended from the base of the skull to the mediastinum associated with similar pelvic and sacral foraminal masses. The target like MRI aspect on T2-weighted images was suggestive of the neural origin. Biopsy under ultrasound control confirmed the diagnosis of plexiform neurofibroma.

Laryngeal Papillomatosis in Adults: Assessment for Ten Years at the ENT Department of the National University Hospital of Fann (Dakar, Senegal)

Objectives. The aim of this study was to describe the epidemiological, diagnostic, and therapeutic aspects of adult laryngeal papillomatosis in Senegal. Patients and Methods. This is a retrospective descriptive study of patients aged above 18 years with laryngeal papillomatosis and followed at the ENT department of the NUH of Fann between 01 January 2009 and 31 December 2018. Results. The mean age at diagnosis was 37.74 years and a sex ratio of 0.93. The 20–29 age group was the most represented (45.2%). The average consultation delay was 8.34 years. All patients had dysphonia at the moment of the diagnostic and in 35.5% of cases, and it was associated with laryngeal dyspnea. Glottis localization was present in all our patients, i.e., 100% of the cases. A tracheotomy was performed in 9.67% of cases. All of our patients have had their papilloma peeled per endoscopic with tweezers. No cases of malignant degeneration were found in our study. Conclusion. Laryngeal papillomatosis is the most common benign tumor of the larynx in both children and adults. Despite the progress of endoscopy and antiviral treatments, its treatment poses many problems in our undermedicalized countries.

A Rare Cause of Upper Airway Obstruction in a Child

Ventricular band cyst is a rare condition in children but can result in severe upper airway obstruction with laryngeal dyspnea or death. The diagnosis should be considered in any stridor in children with previous history of intubation or respiratory infections. We report a case of a 4-year-old girl, received in an array of severe respiratory distress, emergency endoscopy was done, and a large ventricular tape band cyst obstructing the air way was found. Complete excision was made, and postoperative prophylaxis tracheotomy was done. The postoperative course was uneventful with improvement of clinical and endoscopic signs.