Pleomorphic Adenomas of the Parapharyngeal Space

Abstract

Background. Parapharyngeal space is one of potential facial planes for neoplasms and infections and represents less than 1% of all head and neck tumours. Occurrence of the pleomorphic adenoma in the parapharyngeal space is a rarity. Case Presentation. Here, three giant pleomorphic adenomas of different sizes occupying the parapharyngeal space in three patients are reported. Extensive preoperative diagnostic workup was done in order to verify the nature and size of the tumour and the proximity to the large vessels. Review of the literature, clinical features, pathology, radiological findings, and treatment of these tumours are discussed. Conclusion. The excision of the tumor through submandibular transcervical approach, without cutting the mandible, turned out to be a safe and radical approach in all three cases.

Pleomorphic adenoma in para pharyngeal space: a rare presentation

“…For this reason, tumors deep in the parotid gland can present as parapharyngeal masses. 2 In diagnostic workup complete blood count done, followed by fine needle aspiration cytology (FNAC), computerized tomography (CT), and magnetic resonance imaging (MRI) studies to determine the extent of disease, local spread, and even the type of tumour. MRI has been shown to be superior to computed tomography in the investigation of parapharyngeal space tumours.…”

“…The main structures contained in anterior compartment include the pterygoid and tensor palatni muscles, fat and deep lobe of the parotid gland. 2 Parapharyngeal space may become involved by various infectious, inflammations, and neoplasms in head and neck. Both benign and malignant tumors may arise from any structure contained within the PPS where 70-80% appears to be benign and 20-30% appears to be malignant.…”

“…Most of the tumours arising from the posterior compartment are of neurogenic origin while salivary gland tumours are predisposing the anterior compartment. 2 The most common tumors arising in the parapharyngeal space are of salivary gland origin, which account for 40-50% of parapharyngeal lesions and are located in the prestyloid parapharyngeal space. These tumors may originate either in deep lobe of parotid gland, in ectopic salivary gland nests, or in minor salivary glands of the lateral pharyngeal wall.…”

Obstructive sleep apnoea caused by a pleomorphic adenoma: a case report

“…14 The smaller the salivary gland that is affected, the more likely it is to trigger a malignant tumour. 10 The diagnostic work-up begins with haematologic and serologic tests followed by imaging 6 . MRI provides precise information about tumour margins as well as the relationship with the surrounding structures.…”

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“…4 Spiro in his study of 2078 patients with salivary gland neoplasia reported that 20-40% of all salivary gland tumours arise from minor salivary glands, mostly from the palate (42.63%), lip (10%), buccal mucosa (5.5%), retromolar area (0.7%) as well as floor of the mouth, tongue, tonsil, pharynx and nasal cavity. [5][6][7][8][9] In rare occasions, obstructive sleep apnoea is a result of anatomical abnormalities such as a mass in the upper aerodigestive tract. Apart from obstructive sleep apnoea, tumours of this location may also cause dyspnoea, dysphagia and airway obstruction.…”