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<p>Cartilaginous tumors of the larynx are among its rarest pathologies, accounting for &lt; 1% of all laryngeal neoplasms. Within this spectrum, the cricoid cartilage is the usual host, the epiglottis, however, is an almost unheard-of site. Their deceptive appearance, often mimicking malignant disease, makes them diagnostic impostors that challenge clinical acumen. A 63-year-old gentleman presented with a progressively worsening hoarseness, exertional breathlessness, and an elusive “lump-in-throat” sensation. Laryngoscopy unveiled a pale, lobulated supraglottic mass partially concealing the glottic inlet. Radiology deepened the suspicion- circumferential supraglottic thickening with airway narrowing, a picture ominously reminiscent of carcinoma. Yet, the smooth, non-ulcerated surface left room for doubt- was this a malignancy in disguise, or a masquerader with benign intent? Direct laryngoscopic biopsy was performed. Intra-operatively, the mass appeared firm yet uncharacteristically bloodless, its behaviour not entirely malignant. Histopathology clinched the truth- lobules of mature hyaline cartilage, devoid of atypia- an epiglottic chondroma, unveiled at a site where few would expect it. The patient remains under vigilant endoscopic surveillance, symptomatically improved on follow-up. This case epitomizes the clinical conundrum posed by cartilaginous tumors of the larynx. While supraglottic carcinoma dominates the differential in such presentations, the possibility of a benign impostor cannot be overlooked. The rarity of epiglottic chondroma, coupled with its malignant mimicry, underscores the indispensable role of histopathology in resolving the suspense. For the clinician, this case is a reminder that not all sinister-appearing supraglottic lesions are malignant. Awareness of such rare masqueraders prevents over-treatment and refines diagnostic vigilance. Epiglottic chondroma is a benign rarity presenting as a malignant impostor. Its recognition enriches the spectrum of laryngeal pathology and highlights the perennial truth- histopathology has the final word.</p>

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The Benign Impostor of Airway: Epiglottic Chondroma Unveiled at a Rare Supraglottic Site

  • 期刊论文

  • 发表日期：

    2025年11月15日

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  • Sandeep Dabhekar,
  • Nisha Meshram,
  • Nittika Garg,
  • K. Khadeeja,
  • Rohit Bhondekar,
  • Sanskriti Jaiswal

摘要

Cartilaginous tumors of the larynx are among its rarest pathologies, accounting for < 1% of all laryngeal neoplasms. Within this spectrum, the cricoid cartilage is the usual host, the epiglottis, however, is an almost unheard-of site. Their deceptive appearance, often mimicking malignant disease, makes them diagnostic impostors that challenge clinical acumen. A 63-year-old gentleman presented with a progressively worsening hoarseness, exertional breathlessness, and an elusive “lump-in-throat” sensation. Laryngoscopy unveiled a pale, lobulated supraglottic mass partially concealing the glottic inlet. Radiology deepened the suspicion- circumferential supraglottic thickening with airway narrowing, a picture ominously reminiscent of carcinoma. Yet, the smooth, non-ulcerated surface left room for doubt- was this a malignancy in disguise, or a masquerader with benign intent? Direct laryngoscopic biopsy was performed. Intra-operatively, the mass appeared firm yet uncharacteristically bloodless, its behaviour not entirely malignant. Histopathology clinched the truth- lobules of mature hyaline cartilage, devoid of atypia- an epiglottic chondroma, unveiled at a site where few would expect it. The patient remains under vigilant endoscopic surveillance, symptomatically improved on follow-up. This case epitomizes the clinical conundrum posed by cartilaginous tumors of the larynx. While supraglottic carcinoma dominates the differential in such presentations, the possibility of a benign impostor cannot be overlooked. The rarity of epiglottic chondroma, coupled with its malignant mimicry, underscores the indispensable role of histopathology in resolving the suspense. For the clinician, this case is a reminder that not all sinister-appearing supraglottic lesions are malignant. Awareness of such rare masqueraders prevents over-treatment and refines diagnostic vigilance. Epiglottic chondroma is a benign rarity presenting as a malignant impostor. Its recognition enriches the spectrum of laryngeal pathology and highlights the perennial truth- histopathology has the final word.