We describe a unique case of an 18-year-old man referred to otolaryngology on call, as tonsillitis. He gave a 4-day history of progressive dysphagia, change in voice, and globus. No past medical history was given, and vital observations were stable. On clinical examination, his tonsils were unremarkable. Inflammatory markers were within normal limits. Flexible nasoendoscopy revealed a 5-cm oropharyngeal cyst, arising from the left vallecula. His airway was distorted with no view of the vocal cords. Initial management with antibiotics, steroids, and intravenous fluids stabilized his condition. A computed tomography neck with contrast confirmed the cyst to be an isolated lesion. A magnetic resonance imaging excluded the differential of lingual thyroid tissue. The patient was taken to the theater for marsupialization of the cyst, normalizing his airway. He was discharged the following day symptom-free.

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There are various anecdotal reports and case series in the literature on congenital laryngeal cyst. These studies described pathology, presentation, and management of these cysts. The current case series is 2-year retrospective analysis of symptomatology and therapeutic difficulties on seven infants with laryngeal cysts. All the babies presented with moderate-to-severe stridor. Vallecular and base of tongue cyst are the most common sites. Flexible laryngobronchoscopy remains the main diagnostic test. The management initiated by the preoperative use of high-flow nasal cannula and followed by decompression (aspiration) and deroofing. Deroofing done by using the various energy sources such as coblation and lasers (carbon dioxide and diode). Coblation is faster, easier to use with no risk of fire, and bleeding.

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Very small number of minor salivary glands is seen around the larynx and trachea. A tumor originating from the salivary glands is infrequently seen in the respiratory tract. Pleomorphic adenoma (PA) is a benign tumor that can be seen on the head and neck area, most frequently involving major salivary glands. PA originating from the tracheobronchial tree is very rare. We describe here one of such cases, detected during the workup of a health-care worker that became infected with coronavirus disease 2019. Clinicians should be aware of benign tumors arising from the tissues of the central airways and avoid late diagnosis.

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