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Vol. 54. Núm. 2.
Páginas 100 (Febrero 2018)
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Vol. 54. Núm. 2.
Páginas 100 (Febrero 2018)
Clinical Image
DOI: 10.1016/j.arbres.2017.06.017
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Anterior Cervical Osteophyte Presenting as a Pharyngeal Mass
Osteofito cervical anterior que se presenta como una masa faríngea
Visitas
...
Raquel Marçôa
Autor para correspondencia
anamarcoa@hotmail.com

Corresponding author.
, Ricardo Lima, Carla Ribeiro
Serviço de Pneumologia, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
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We describe the case of a 73-year-old-man, non-smoker, with recurrent respiratory infections. He had a medical history of bronchiectasis and an asthma/COPD overlap syndrome.

The patient was submitted to a fiberoptic bronchoscopy, which showed a tumefaction in the posterior wall of hypopharynx and inferior oropharynx, approximately 2cm in diameter, with hard consistency and preserved mucosa (Fig. 1A). Cervical computed tomography (CT) revealed extrinsic compression of the posterior wall of pharynx, caused by large osteophytes of the cervical vertebrae (Fig. 1B).

Fig. 1.

(A) A tumefaction in the posterior wall of hypopharynx and inferior oropharynx visualized by fiberoptic bronchoscopy. (B) Cervical computed tomography (sagittal) showing large cervical anterior osteophytes.

(0,12MB).

Anterior cervical osteophytes have a prevalence of 20–30% in the elderly population and are diagnosed on the basis of radiologic findings. They are generally asymptomatic; however, in rare cases, they can lead to dysphagia, dysphonia, and dyspnoea.1

Asymptomatic patients, like the case referred, don’t need treatment. Symptomatic patients should be treated according to the severity of disease. Initial conservative management includes diet modifications, muscle relaxants, antireflux and anti-inflammatory medications.2 Surgical intervention (osteophytectomy) is indicated in patients for whom conservative treatment fails and those with respiratory complaints. A tracheostomy is needed concurrently to surgery in individuals with presurgical respiratory complaints.2

Anterior cervical osteophytes can be an important cause of dysphagia and postoperative complications especially in the elderly. Thus, their recognition may be important in the preoperative evaluation of the elderly patient (namely those symptomatic) and in the differential diagnosis of dysphagia.

References
[1]
A. Akbal, A. Kurtaran, B. Selcuk, A. Gurcan, M. Ersoz, M. Akyuz.
The development of dysphagia and dysphonia due to anterior cervical osteophytes.
Rheumatol Int, 29 (2009), pp. 331-334
[2]
M.L. Carlson, D.J. Archibald, D.E. Graner, J.L. Kasperbauer.
Surgical management of dysphagia and airway obstruction in patients with prominent ventral cervical osteophytes.
Dysphagia, 26 (2011), pp. 34-404
Copyright © 2017. SEPAR
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