S143 – Benign and Malignant Lipogenic Tumors of the Retropharynx

Abstract

Objectives

Lipogenic tumors of the retropharyngeal space are neoplasms that can grow to a considerable size before becoming symptomatic. In this study we compare clinical, radiologic, and histologic findings of benign versus malignant lipogenic tumors of the retropharyngeal space.

Methods

Retrospective review of a case series.

Results

2 patients were identified with large lipogenic tumors of the retropharynx. The first patient was 66-year-old female with a 6-week history of progressive airway difficulty and dysphagia requiring tracheostomy and gastrostomy-tube placement. Preoperative imaging revealed a lipoma of the retropharynx. A transcervical excision of her retropharyngeal mass revealed a 10⋉9⋉4.8 cm lipoma. The second patient was a 57-year-old female with a 4-week history of progressive left neck swelling, airway compromise, and odynophagia. Preoperative imaging revealed a heterogeneous mass in the retropharynx with fatty and solid components. After an initial awake tracheostomy a transcervical excision of a 15⋉5.5⋉4.0 cm mass was performed. Pathology revealed liposarcoma with scattered dedifferentiated regions. Postoperative radiation therapy was given for focally positive surgical margins. Both patients are recurrence-free at 36 months follow-up.

Conclusions

Although lipogenic tumors of the retropharyngeal space are rare these cases illustrate that they present at advanced stages, often requiring tracheostomy for airway control. The clinical course of lipomas and liposarcomas can be similar. However, careful inspection of preoperative imaging will heighten suspicion for malignancy, which is critical in surgical planning.