Mushi E, Winter S
Department of Otolaryngology and Head and Neck Surgery, University Hospital Aintree, Liverpool, UK.
J Laryngol Otol. 2013 Jan;127(1):104-6. doi: 10.1017/S0022215112002459. Epub 2012 Dec 7.
Parapharyngeal space tumours are uncommon and represent 0.5-1 per cent of all head and neck neoplasms; 20-30 per cent of these are malignant. Malignant peripheral nerve sheath tumours are rare and mostly encountered in patients with neurofibromatosis type 1. Only four cases of parapharyngeal space tumours have been reported in the English language in patients without neurofibromatosis type 1.
We report the case of a 64-year-old man with no stigmata of neurofibromatosis type 1, in whom a mass in the left pre-styloid region of the parapharyngeal space was an incidental finding following magnetic resonance imaging for investigation of cervical spine problems. The mass was consequently removed using a transcervical approach. A histological review revealed a low-grade malignant peripheral nerve sheath tumour.
We consider the pathophysiology of this highly malignant tumour as well as the challenging anatomy of the parapharyngeal space and the surgical and other therapeutic modalities utilised to treat this condition.
咽旁间隙肿瘤并不常见，占所有头颈部肿瘤的0.5% - 1%；其中20% - 30%为恶性。恶性外周神经鞘瘤罕见，多见于1型神经纤维瘤病患者。在无1型神经纤维瘤病的患者中，英文报道的咽旁间隙肿瘤仅有4例。
我们报告一例64岁男性，无1型神经纤维瘤病体征，因颈椎问题行磁共振成像检查时偶然发现咽旁间隙茎突前区左侧有一肿块。随后采用经颈入路将肿块切除。组织学检查显示为低度恶性外周神经鞘瘤。
我们探讨了这种高度恶性肿瘤的病理生理学，以及咽旁间隙具有挑战性的解剖结构，以及用于治疗该疾病的手术和其他治疗方式。
