A Rare Nasopharyngeal Hemangioma Presenting as Recurrent Cyanotic Apnea in a Neonate: A Case Report and Literature Review.

Abstract

Background: Infantile hemangiomas (IHs) are the most common vascular tumors of infancy, but airway involvement is rare and potentially life-threatening. While subglottic and laryngeal regions are most frequently affected, nasopharyngeal hemangiomas are exceptionally uncommon, particularly in premature infants presenting with nonspecific symptoms such as apnea and cyanosis. Case Presentation: We describe a female infant born prematurely at 35 weeks via cesarean section, who developed recurrent apnea and cyanotic episodes shortly after discharge. Flexible bronchoscopy revealed a nasopharyngeal mass causing upper airway obstruction, and imaging raised suspicion of a hemangioma. The patient underwent surgical excision of the lesion and was started on a tapering course of prednisolone. Postoperative recovery was favorable, and oral propranolol was initiated to prevent recurrence. At follow-up, the patient demonstrated normal development without respiratory symptoms. Conclusion: Nasopharyngeal hemangiomas are rare and may present subtly in premature infants. Early bronchoscopy and imaging should be considered in cases of unexplained apnea or airway compromise. A multidisciplinary approach ensures timely diagnosis and effective treatment, minimizing long-term respiratory complications.