Large Cervical Osteophytes Mimicking a Hypopharyngeal Neoplasm

Matteo Pezzoli^1, , Sebastiano Bucolo¹, Federico Griva² and Alessandro Pagliassotto¹

¹ENT Unit, Ospedale San Giovanni Bosco, Turin, Italy

²Neurosurgery Unit, Ospedale San Giovanni Bosco, Turin, Italy

Cite this paper

Matteo Pezzoli, Sebastiano Bucolo, Federico Griva and Alessandro Pagliassotto. Large Cervical Osteophytes Mimicking a Hypopharyngeal Neoplasm. American Journal of Medical Case Reports. 2021; 9(12):705-708. doi: 10.12691/AJMCR-9-12-11

Abstract

Hypertrophic anterior osteophytes of the vertebrae affecting the anterior longitudinal ligament of the spine are typical of diffuse idiopathic skeletal hyperostosis (DISH), a spinal disorder of the elderly also known as Forestier Disease, from the name of the first author who reported it in 1950. Usually, patients are asymptomatic or have mild dysphagia, due to compression of the digestive tract but less commonly can have acute dyspnea requiring to secure the airway has been rarely reported. Diagnosis is usually obtained with radiologic exams that reveal a bony mass. In some cases, fibrosis and inflammation due to the constant movement of the cricoid lamina over a projecting osteophyte are also seen with the CT Scan. In this paper, we describe a distinct entity of a giant lesion of the cervical spine that appeared as a pseudotumor of cervical soft tissue and caused acute upper airway obstruction requiring emergency tracheostomy. Details of his clinical examination, radiologic imaging, and surgical management are provided and discussed.

Keywords

DISH, Osteophytosis, Tracheostomy, Acute dyspnea

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Bone RC, Nahum AM, Harris AS. Evaluation and correction of dysphagia-producing cervical osteophytosis. Laryngoscope. 1974; 84: 2045-2050.
[2]	Hardin JG, Halla JT. Cervical spine and radicular pain syndromes. Curr Opin Rheumatol 1995; 7: 136-140.
[3]	Saffouri HH, Ward PH: Surgical correction of dysphagia due to cervical osteophytes. Ann Otol Rhinol Laryngol. 83: 65-70, 1974.
[4]	Resnick D, Shaul SR, Robins JM. Diffuse idiopathic skeletal hyperostosis (DISH): Forestier’s disease with extraspinal manifestations. Radiology 1975; 115: 513-524.
[5]	Giger R, Dulguerov P, Payer M. Anterior cervical osteophytes causing dysphagia and dyspnea: an uncommon entity revisited. Dysphagia 2006; 21: 259-63.
[6]	Dagher W, Nasr V, Patel AK, Flis D, and Wein R. An Unusual and Rare Cause of Acute Airway Obstruction in the Elderly: Forestier’s Disease. Journal of Emergency Medicine, 46 (2014), 617-19.
[7]	Sobol SM, Rigual NR. Anterolateral extrapharyngeal approach for cervical osteophyte-induced dysphagia; literature review. Ann Otol Rhinol Laryngol 1984; 93: 498-504.
[8]	Ohki M. Dysphagia due to diffuse idiopathic skeletal hyperostosis. Case Reports in Otolaryngology. 2012; 2012: 123825.
[9]	Carlson ML, Archibald DJ, Graner DE, et al. Surgical management of dysphagia and airway obstruction in patients with prominent ventral cervical osteophytes. Dysphagia 2011; 26: 34-40.
[10]	S. Uppal and A. H. Wheatley, “Transpharyngeal approach for the treatment of dysphagia due to Forestier’s disease,” Journal of Laryngology and Otology, vol. 113, no. 4, pp. 366-368, 1999.