Congenital Hairy Polyp of the Palatopharyngeus Muscle

Purpose. To describe clinical, radiologic, and histological features of a congenital hairy polyp arising from the palatopharyngeus muscle in a neonate. Methods. Chart of a 2-day-old female referred to a tertiary care pediatric hospital for assessment of intraoral mass was reviewed. Results. The child was born at 32 weeks and an intraoral mass was noted. The patient was transferred to tertiary care children’s hospital on day 2 of life. The child had increased work of breathing at presentation and required continuous positive airway pressure. Physical examination revealed a pedunculated mass which was protruding into the oropharynx from the nasopharynx. MRI of the lesion documented a discrete bilobed mass which filled the posterior nasopharynx. The mass abutted the uvula and soft palate; however, the mass did not appear to be arising from the soft palate. Intraoperative exam showed a mass arising from the right palatopharyngeus muscle in the superior pole region of the tonsil. Histologic examination showed ectodermal and mesodermal derivatives confirming congenital hairy polyp. At 8-month followup, the surgical site was healed with no evidence of recurrent lesion. Conclusions. Congenital hairy polyp, though uncommon, should be considered in the differential diagnosis of oropharyngeal mass in neonates. 1. Introduction Congenital hairy polyp is a rare malformation that consists of mesodermal and ectodermal elements [1]. Hairy polyp has shown 6？:？1 female predilection [1]. A wide variety of congenital anomalies including, but not limited to, cleft palate, agenesis of the uvula, external auricle, ankyloglossia, facial hemihypertrophy, left carotid artery atresia, and osteopetrosis have been documented in patients with hairy polyp [2]. To date, hairy polyp has been documented in the nasopharynx, soft and hard palate, tongue, pharynx, tonsil, palatopharyngeus and palatoglossus muscles, external auditory canal, middle ear, mastoid, hypopharynx, esophagus, and trachea [3]. This retrospective case review describes clinical, radiologic, and histological features of a congenital hairy polyp arising from the palatopharyngeus muscle in a neonate. 2. Case Report The child was born at 32 weeks to a mother with no medical problems. At the initial exam, an intraoral mass was noted and the patient was transferred to tertiary care children’s hospital on day 2 of life. The child had increased work of breathing at presentation and required continuous positive airway pressure. Family history was unremarkable. Physical examination revealed well-appearing child in no respiratory