Large Cervical Osteophytes Mimicking a Hypopharyngeal Neoplasm

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.