Laryngeal ectopic tonsillar tissue as a cause of dysphagia: a case report and literature review.

Ectopic tonsillar tissue outside Waldeyer's ring is rare, with laryngeal involvement being significantly uncommon. Only four cases of laryngeal ectopic tonsillar tissue have been previously documented, all in older adults presenting mostly with dysphonia. A 31-year-old male smoker presented with intermittent dyspnea and dysphagia. His medical history included chronic reflux managed with proton pump inhibitors. Flexible nasal endoscopy revealed a left aryepiglottic fold mass, later confirmed by computed tomography as a 4 × 4 mm non-enhancing nodule. Microlaryngoscopic excision was performed under general anesthesia. The patient experienced complete symptom resolution with no recurrence at 6-month follow-up. This case highlights an unusual presentation of laryngeal ectopic tonsillar tissue in a younger patient with airway symptoms rather than voice changes. It emphasizes the importance of including benign lymphoid proliferations in the differential diagnosis of laryngeal masses. Surgical excision is both diagnostic and therapeutic, with excellent outcomes and minimal recurrence risk.