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An infant boy known to have a secondary cleft palate presented with apneic episodes and sternal retractions. He had been delivered vaginally at term, with the pregnancy complicated by preeclampsia and oligohydraminos.
On examination there was a 3-cm, smooth, whitish tan mass emanating from the right lateral pharyngeal wall (Figure, A) and protruding down through the secondary cleft palate. A contrast-enhanced maxillofacial computed tomographic (CT) scan was obtained. This revealed a well-defined, round heterogeneous, midline mass obstructing the oropharynx and posterior nasopharynx (Figure, B-D). The mass had a mildly enhancing thick wall with a central focus of decreased enhancement, with attenuation similar to fluid. No discrete foci of calcification or fat were identified.
Harbarger CF, Prosser JD, Hughes CA, Borders JC. Apneic Episodes and Sternal Retractions in an Infant. JAMA Otolaryngol Head Neck Surg. 2013;139(9):957-958. doi:10.1001/jamaoto.2013.4092