Parapharyngeal Space Tumours

Abstract

Tumours in the parapharyngeal space have been difficult diagnostic and management problems. Consideration of the anatomy in three dimensions may be illustrated with computed tomography. Fifteen patients with parapharyngeal space tumours are presented, including six salivary gland tumours, four neurogenic tumours and five tumours from miscellaneous origin. The tumours were all treated by surgical excision. The preferred approach was the transcervical route. Additional procedures, including total conservative parotidectomy, were carried out depending on the pathology. Mandibulotomy was required for only one patient whose tumour had infiltrated the base of the skull and extended intracranially.

Parapharyngeal lymph node metastasis: An unusual presentation of papillary thyroid carcinoma

“…Lymph nodes in the poststyloid compartment of the PS are more frequently involved by pharyngeal or sinonasal squamous cell carcinoma and lymphomas. The occurrence of a metastasis from a well-differentiated thyroid carcinoma in the PS is an exceedingly rare event, with only 10 cases from papillary carcinoma 6 -13 and 2 cases from follicular carcinoma 3,4 reported to date. Interestingly, the case described by Sirotnak et al 8 was subsequently published by Carter et al 15 with an updated follow-up.…”

“…On cross-sectional imaging, the differential diagnosis of cystic lesions arising in the poststyloid compartment of the PS should include cystic schwannoma, neurofibroma, inflammatory adenopathies, necrotic nodal metastases or lymphomas, cystic hygroma, and pseudoaneurysms of the ICA. Branchial cleft cysts 1,4,14,25,26 arise instead in the prestyloid compartment.…”

UNUSUAL MASS IN THE PARAPHARYNGEAL SPACE: A WARTHIN's TUMOUR

“…Parapharyngeal space tumours are usually asymptomatic in the early phase and, as a result, most of the patients usually present with advanced and large‐sized disease. It is important to make an accurate diagnosis as early as possible in the course of the disease to avoid serious complications such as airway obstruction 1 …”

“…However, tumours at an early stage are difficult to diagnose as the symptoms are often not present or they are vague and non‐specific. If the tumours are not diagnosed early, continued expansion of even benign tumours may result in potential life‐threatening complications, such as airway obstruction, and may lead to cranial nerve compression with significant organ dysfunctions 1 . Salivary gland tumours, in particular pleomorphic adenoma, account for most of the PPS tumours 1–3 .…”

Editorial to: “Transoral resection of large parapharyngeal space tumors” by Hussain et al.

“…It is very important to emphasize that a transoral removal, i.e. the approach used in the presented study, is associated with an unacceptably high rate of tumor rupture and recurrence for pleomorphic adenomas of the parapharyngeal space managed by transoral removal [1,2,4,5,8]. Moreover, it is difficult to follow the terminology used by Hussain et al to describe their transoral approach: the authors describe the technique with the term ''extracapsular dissection'' although some tumors were resected with piecemeal technique or cored out with an ultrasonic aspirator or with a microdebrider.…”