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Abnormalities of the atlantoaxial spine are very rare variants. Bony outgrowths, osteophytes, clefts and aplasia may be misinterpreted as degenerative diseases. One patient presented with intermittent dysphagia and snoring and CT and MRI scans of the cervical spine showed an accessory bone located anterior to the atlas and axis. Atlantoaxial anomalies are often incidental findings without clinical symptoms. Such changes are rarely the cause of intermittent dysphagia and snoring.

We describe a case of pedunculated hypopharyngeal lipoma with radiographic and endoscopic correlation. This 66-year-old man presented with 3 years of intermittent dysphagia for solids and unrelated episodes of coughing. The literature regarding benign pedunculated polyps of the hypopharynx and proximal esophagus is reviewed. The clinical presentation, diagnostic workup, and recommended therapy for these unusual lesions are discussed.