Congenital laryngeal hamartoma with ectopic thymus causing airway compromise in a neonate

To describe an interesting clinical and histopathologic case of a neonate presenting with respiratory distress and a laryngeal hamartoma with ectopic thymus and parathyroid tissue. Case report and PubMed review of the English literature. A full term, newborn male who presented immediately after birth with postitional, inspiratory stridor and airway distress. During operative microlaryngoscopy, a well-delineated, non-cystic, stalk-like mass was found in the endolarynx. Biopsy revealed thymic tissue with Hassall's corpuscles, parathyroid tissue and a central core of mature fibroadipose tissue and skeletal muscle. The mass was removed endoscopically with cold instrumentation. At 4 months postoperatively, the patient was doing well, without any respiratory symptoms, feeding difficulties, or endoscopic findings of recurrence. Neonatal laryngeal hamartomas are extremely rare. In general, an excellent prognosis is associated with these lesions, and the treatment of choice is endoscopic, surgical excision. This case is histopathologically unique because it is the first to encounter the presence of thymic and parathyroid tissue within a glandular hamartoma.