A case report: anesthetic management of a patient with unexpected difficult airway due to an asymptomatic giant epiglottic cyst

Abstract Background Giant asymptomatic epiglottic cysts are rare, benign lesions that can cause life-threatening airway obstructions during general anaesthesia induction. Objective To describe the clinical recognition, perioperative evaluation, and successful anaesthetic management of an unexpected difficult airway caused by an undiagnosed giant epiglottic cyst and to share the clinical experience. Case presentation A 60-year-old woman presented for elective laparoscopic cholecystectomy. After induction, video laryngoscopy revealed a giant cyst obscuring the view of the glottis. The airway was successfully secured using a two-person cooperative manoeuvre, with mask ventilation remaining effective throughout. Conclusion Comprehensive preoperative assessment is critical; however, asymptomatic giant epiglottic cysts present a hidden airway risk. Timely video laryngoscopy and adequate support ensure patient safety.