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

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.