The Ventricle’s Vascular Secret: A Rare Case of Pyogenic Granuloma of the Larynx

Abstract

Introduction
This case report highlights an exceptionally rare presentation of pyogenic granuloma (lobular capillary hemangioma) arising from the right laryngeal ventricle in a young adult with no history of trauma, voice abuse, surgery, or known risk factors. Pyogenic granulomas are common in cutaneous and mucosal locations but are unusual in the larynx, especially within the ventricle. This case adds to the limited literature on laryngeal vascular lesions in non-smoking, otherwise healthy young adults, reinforcing the importance of considering benign vascular etiologies in the differential diagnosis of sudden-onset dysphonia.
Patient Presentation and Clinical Findings
A 28-year-old male presented with:
⦁    Sudden-onset hoarseness of voice
⦁    Odynophagia (painful swallowing)
⦁    Mild dysphagia (difficulty swallowing)
Duration: 1 month
Relevant negatives:
⦁    No history of smoking, alcohol use, vocal strain, trauma, prior surgery, or allergies
Examination:
⦁    Indirect laryngoscopy showed a sessile, slough-covered, broad-based mass arising from the right laryngeal ventricle
⦁    Vocal cord mobility preserved
⦁    No other mucosal abnormalities or signs of malignancy
Initial Differential Diagnoses:
⦁    Laryngeal hemangioma
⦁    Papilloma
⦁    Ventricular cyst
⦁    Laryngocele with infection

Diagnosis, Intervention, and Outcome
Procedure:
⦁    Direct laryngoscopy under general anesthesia
⦁    The mass was found not attached to the false vocal cord but originating from the ventricular mucosa
⦁    Complete excision performed
Histopathology:
⦁    Lobular capillary hemangioma (pyogenic granuloma)
⦁    No features of dysplasia or malignancy
Final Diagnosis:
⦁    Pyogenic granuloma of the right laryngeal ventricle
Outcome:
⦁    Complete resolution of symptoms
⦁    No recurrence at follow-up
Conclusion -
This rare case highlights how a seemingly isolated symptom can point to a rare, hidden pathology. The isolated presentation and complete recovery after excision emphasize the effectiveness of early intervention. It's a vivid reminder that timely, precise surgical management can be both diagnostic and curative -turning uncertainty into clarity and restoring patient's quality of life.