Stridor is not always croup: infantile haemangioma in the airway

Description

A 12-month-old boy presented with a history of respiratory distress and stridor since the first month of life. He had been repeatedly misdiagnosed as recurrent croup. The stridor was biphasic, with a more pronounced inspiratory component, and was exacerbated by agitation and supine positioning. He had a large posterior cervical haemangioma, whose extension had never been studied by imaging methods, and delayed growth. Flexible bronchoscopy showed a multilobulated subglottic haemangioma (SGH), occupying more than 70% of the tracheal lumen. MRI showed an angiomatous malformation with the epicentre at the hind head that extended inferiorly to the cervical planes, reaching the median line in retropharyngeal planes with inferior extension (figures 1 and 2). He underwent systemic and intralesional tracheal steroids injections with partial improvement and laser therapy at 5 years of age. Today he is an asymptomatic 14-year-old adolescent with normal growth and development.

Figure 1

Cervical...

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