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<p>Retropharyngeal space lesions in children are most commonly infective; however, malignant tumors may rarely mimic retropharyngeal abscess, leading to diagnostic delay and life-threatening airway compromise. We report a 7-year-old girl presenting with acute neck swelling, dysphagia, and progressive respiratory distress. Initial lateral soft tissue neck radiograph suggested a retropharyngeal abscess, but intraoral aspiration yielded a bloody tap. Contrast-enhanced CT revealed a large, vascular retropharyngeal mass with extensive airway displacement and lymphadenopathy, favoring a neoplastic etiology. Rapid deterioration necessitated an emergency tracheostomy, which was technically challenging due to marked tracheal deviation. Histopathology revealed a small round cell tumor, most consistent with non-Hodgkin lymphoma, supported by elevated serum LDH and significant family history of hematological malignancy. This case highlights the aggressive nature of pediatric retropharyngeal malignancies and the importance of early airway preparedness (LeRiger in Int Med Case Rep J 10:381–384, 2017; Craig in Ann Emerg Med 41:95–100, 2003; Dudas in Pediatrics 104:1394–1398, 1999; Costa in AJR Am J Roentgenol 196:W433–W437, 2011; Sharma in Indian J Med Paediatr Oncol 38:349–353, 2017; Cohn in J Pathol 155:11–17, 1997; Rajwanshi in J Cytol 26:1–10, 2009; Singh in J Oral Maxillofac Pathol 16:386–391, 2012).</p>

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A Rapidly Progressive Retropharyngeal Small Round Cell Tumor Mimicking Retropharyngeal Abscess in a Child: A Diagnostic and Airway Challenge

  • 期刊论文

  • 发表日期：

    2026年3月9日

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  • Avisha Sharma,
  • Smita Soni,
  • Harshit Wadbude,
  • Amit Kumar

摘要

Retropharyngeal space lesions in children are most commonly infective; however, malignant tumors may rarely mimic retropharyngeal abscess, leading to diagnostic delay and life-threatening airway compromise. We report a 7-year-old girl presenting with acute neck swelling, dysphagia, and progressive respiratory distress. Initial lateral soft tissue neck radiograph suggested a retropharyngeal abscess, but intraoral aspiration yielded a bloody tap. Contrast-enhanced CT revealed a large, vascular retropharyngeal mass with extensive airway displacement and lymphadenopathy, favoring a neoplastic etiology. Rapid deterioration necessitated an emergency tracheostomy, which was technically challenging due to marked tracheal deviation. Histopathology revealed a small round cell tumor, most consistent with non-Hodgkin lymphoma, supported by elevated serum LDH and significant family history of hematological malignancy. This case highlights the aggressive nature of pediatric retropharyngeal malignancies and the importance of early airway preparedness (LeRiger in Int Med Case Rep J 10:381–384, 2017; Craig in Ann Emerg Med 41:95–100, 2003; Dudas in Pediatrics 104:1394–1398, 1999; Costa in AJR Am J Roentgenol 196:W433–W437, 2011; Sharma in Indian J Med Paediatr Oncol 38:349–353, 2017; Cohn in J Pathol 155:11–17, 1997; Rajwanshi in J Cytol 26:1–10, 2009; Singh in J Oral Maxillofac Pathol 16:386–391, 2012).