Spontaneous Rupture of a Hypopharyngeal Cyst in an Elderly Bedridden Patient

TL;DR

An elderly patient with a large hypopharyngeal cyst experienced spontaneous rupture and symptom resolution without surgery.

Contribution

This case highlights the rare possibility of spontaneous cyst rupture and suggests conservative management in high-risk patients.

Findings

Spontaneous rupture of a hypopharyngeal cyst resolved dysphagia without complications.

Conservative observation may be viable in high-risk patients when surgery is not feasible.

The case adds to limited literature on hypopharyngeal cyst natural history.

Abstract

Hypopharyngeal cysts are rare benign lesions that may present with dysphagia and, less commonly, airway compromise and are typically managed surgically. We report the case of an 80-year-old bedridden man with multiple comorbidities who presented with progressive dysphagia due to a large hypopharyngeal cyst causing mechanical obstruction. Surgical intervention was recommended but declined by the patient’s family due to the patient’s frailty. Unexpectedly, the cyst spontaneously ruptured during hospitalization, resulting in immediate and complete resolution of dysphagia without aspiration, respiratory compromise, or other complications. Follow-up endoscopy and imaging confirmed resolution of the lesion and normalization of hypopharyngeal anatomy. This case represents a rare and unexpected clinical scenario and contributes to the limited literature on the natural history of hypopharyngeal cysts. It highlights that, in carefully selected high-risk patients with a stable airway, conservative observation may be a reasonable management option when surgical intervention is contraindicated.

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