Li Fengzhen, Cha Xudong, Wang Shenglei, Xie Yingqi, Xu Zengyi, Liu Huanhai
Department of Otolaryngology-Head and Neck Surgery, Second Affiliated Hospital of Naval Medical University, Shanghai, China.
J Craniofac Surg. 2024 Sep 19. doi: 10.1097/SCS.0000000000010662.
Parapharyngeal space tumor is a tumor that occurs in the parapharyngeal space. Parapharyngeal space tumors are uncommon, accounting for about 0.5% of head and neck tumors. Eighty percent of them are benign and 20% are malignant. The pathologic types of tumors are varied, mainly neurogenic tumors and salivary gland tumors. Follicular dendritic sarcomas are much rarer, with an inert biological behavior and a low-grade malignant sarcoma. Clinicians face difficulties in the management of this lesion. Therefore, a comprehensive analysis of the management of this disease is necessary.
In May 2023, a 22-year-old male presented with pharyngeal discomfort, dysphagia, and sleep apnea. The patient underwent MRI which showed a rounded hypodense shadow with a size of 3.2×2.1×4.5 cm in the left lateral pharyngeal wall and a mass located in the posterior aspect of the left submandibular gland. After preliminary diagnosis of left parapharyngeal space tumor and left neck mass, the clinician performed transoral endoscopy-assisted resection of the left parapharyngeal space tumor and transcervical resection of the left cervical mass. The patient has been followed up without recurrence.
This case provided a reference for the diagnosis and management of parapharyngeal space tumors. In particular, new insights into the diagnosis and management of a rare pathologic type were presented, which had the potential to improve the overall understanding of this disease.
咽旁间隙肿瘤是发生于咽旁间隙的肿瘤。咽旁间隙肿瘤较为少见，约占头颈部肿瘤的0.5%。其中80%为良性，20%为恶性。肿瘤的病理类型多样，主要为神经源性肿瘤和涎腺肿瘤。滤泡树突状肉瘤更为罕见，具有惰性生物学行为，是一种低级别恶性肉瘤。临床医生在处理该病变时面临困难。因此，有必要对该病的处理进行综合分析。
2023年5月，一名22岁男性因咽部不适、吞咽困难和睡眠呼吸暂停就诊。患者接受了磁共振成像（MRI）检查，结果显示左侧咽侧壁有一个大小为3.2×2.1×4.5厘米的圆形低密度影，左侧下颌下腺后方有一个肿块。在初步诊断为左侧咽旁间隙肿瘤和左侧颈部肿块后，临床医生进行了经口内镜辅助下左侧咽旁间隙肿瘤切除术和经颈左侧颈部肿块切除术。患者已接受随访，无复发。
该病例为咽旁间隙肿瘤的诊断和处理提供了参考。特别是，对一种罕见病理类型的诊断和处理提出了新的见解，这有可能增进对该疾病的整体认识。
