A Large Extra Cranial Cystic Trigeminal Schwannoma of the Parapharyngeal Space – Exploring the Right Approach

Spindle cell lipomas are usually located in the subcutaneous tissue of the back, shoulders, and neck. To our knowledge, the presence of such a tumor in the parapharyngeal space has not yet been described. We evaluated a 45-year-old man with a tender swelling of the right parotid area that had reached the submandibular area. Clinical examination and magnetic resonance imaging revealed the presence of a tumor that coated the parotid area laterally and extended into the center of the parapharyngeal space, thus causing a dislocation of the pharyngeal muscles and mucosa. We performed a total parotidectomy and submandibulectomy on the right side and extirpated the parapharyngeal tumor. We were able to spare the facial nerve, and no facial paralysis occurred. Histologic examination revealed an atypical lipomatous tumor with a remarkably large portion of spindles.

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Three unusual parapharyngeal space masses resected via the endoscopy-assisted transoral approach: case series and literature review

Journal of International Medical Research ◽

10.1177/0300060520936068 ◽

2020 ◽

Vol 48 (8) ◽

pp. 030006052093606

Author(s):

Li-Fang Shen ◽

Ya-Lian Chen ◽

Shui-Hong Zhou

Keyword(s):

Parapharyngeal Space ◽

Case Series ◽

Transoral Approach ◽

Carcinoma Ex Pleomorphic Adenoma ◽

Branchial Cleft Cyst ◽

Current Time ◽

History Of ◽

Cosmetic Outcomes ◽

Branchial Cleft ◽

The Right

Tumors of the parapharyngeal space (PPS) are rare, most originate from salivary and neurogenic tissues, and most are benign. However, there are some rarer masses in the PPS, with just a few published reports in the literature worldwide, and we may not consider them in the differential diagnosis of PPS neoplasms. We report three cases of rare masses in the PPS: Warthin’s tumor, branchial cleft cyst, and carcinoma ex pleomorphic adenoma. The three patients were admitted to our department with complaints of painless swelling in the lower side of the right face or a long history of snoring; diagnoses were confirmed histopathologically. An endoscopy-assisted transoral approach was used that allowed wide visibility for safe resection and resulted in a short hospitalization time and good functional and cosmetic outcomes. All patients have been followed to the current time, and there have been no recurrences. The transoral endoscopy-assisted approach appears to be safe, effective, and less invasive for excision of masses in the PPS.

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Lateral orbitotomy for a maxillary nerve schwannoma: case report

Journal of Neurosurgery ◽

10.3171/2015.7.jns15422 ◽

2016 ◽

Vol 125 (4) ◽

pp. 869-876 ◽

Cited By ~ 3

Author(s):

Scott A. Wallace ◽

R. Michael Meyer ◽

Michael J. Cirivello ◽

Raymond I. Cho

Keyword(s):

Case Report ◽

Scientific Literature ◽

Technical Aspects ◽

Maxillary Nerve ◽

Type D ◽

Trigeminal Schwannoma ◽

Novel Approach ◽

Lateral Orbitotomy ◽

Facial Numbness ◽

The Right

Authors of this report describe a Fukushima Type D(b) or Kawase Type ME2 trigeminal schwannoma involving the right maxillary division in a 59-year-old woman who presented with intermittent right-sided facial numbness and pain. This tumor was successfully resected via a right lateral orbitotomy without the need for craniotomy. This novel approach to a lesion of this type has not yet been described in the scientific literature. The outcome in this case was good, and the patient's intra- and postoperative courses proceeded without complication. The epidemiology of trigeminal schwannomas and some technical aspects of lateral orbitotomy, including potential advantages of this approach over traditional transcranial as well as fully endoscopic dissections in appropriately selected cases, are also briefly discussed.

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Unusual Location for Langerhans Cell Histiocytosis: Basisphenoid extended to Parapharyngeal Space

Otorhinolaryngology Clinics - An International Journal ◽

10.5005/jp-journals-10003-1224 ◽

2016 ◽

Vol 8 (1) ◽

pp. 38-40

Author(s):

Asif Salimov ◽

Ahmet E Suslu ◽

Serdar Ozer ◽

Taner Yilmaz ◽

Hatice IY Bajin

Keyword(s):

Langerhans Cell Histiocytosis ◽

Parapharyngeal Space ◽

Langerhans Cell ◽

Unknown Etiology ◽

Endoscopic Endonasal ◽

Unusual Location ◽

First Case ◽

Rare Location ◽

Magnetic Resonance Imaging Mri ◽

The Right

ABSTRACT Langerhans cell histiocytosis (LCH) is a rare disease with unknown etiology involving abnormal proliferation of histiocytes. We hereby describe an LCH that has a rare location. A 4-year-old female patient was referred to our clinic with headache lasting for 2 months. Magnetic resonance imaging (MRI) showed an expansile mass on the level of basisphenoid extended to the right parapharyngeal space with dense contrast enhancement. The patient underwent endoscopic endonasal transsphenoidal surgery for biopsy of the mass. Immunohistochemical and pathological studies confirmed LCH diagnosis. This is the first case report of LCH extended to the parapharyngeal space in the current literature. How to cite this article Salimov A, Suslu AE, Ozer S, Yilmaz T, Bajin HIY. Unusual Location for Langerhans Cell Histiocytosis: Basisphenoid extended to Parapharyngeal Space. Int J Otorhinolaryngol Clin 2016;8(1):38-40.

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Usefulness of Stereotactic Radiotherapy Using CyberKnife for Recurrent Lymph Node Metastasis of Differentiated Thyroid Cancer

Case Reports in Endocrinology ◽

10.1155/2017/7956726 ◽

2017 ◽

Vol 2017 ◽

pp. 1-3

Author(s):

Joji Kawabe ◽

Shigeaki Higashiyama ◽

Mitsuharu Sougawa ◽

Atsushi Yoshida ◽

Kohei Kotani ◽

...

Keyword(s):

Lymph Node ◽

Lymph Node Metastasis ◽

Lymph Node Metastases ◽

Parapharyngeal Space ◽

Target Volume ◽

Stereotactic Radiation ◽

Node Metastasis ◽

Prescription Dose ◽

Node Metastases ◽

The Right

A woman in her 60s presented with a recurrent lymph node metastasis from a papillary thyroid carcinoma in the right parapharyngeal space. She had already undergone total thyroidectomy, five resections for cervical lymph node metastases, and right carotid rebuilding. Surgical resection of the current metastasis was impossible. 131I-radioiodine therapy (RIT) with 3.7 GBq 131I was not effective; therefore, stereotactic radiation therapy (SRT) using a CyberKnife radiotherapy system was scheduled. The prescription dose was 21 Gy, and a dose covering 95% of the planning target volume (PTV) in three fractions was administered. The PTV was 4,790 mm3. Follow-up magnetic resonance imaging conducted 3 and 12 months after the SRT demonstrated a remarkable and gradual reduction of the recurrent lymph node metastasis in the right parapharyngeal space and no evidence of recurrence. For multidisciplinary therapy of unresectable and/or RIT unresponsive locoregional lymph node metastases and recurrences of DTC, SRT using the CyberKnife system should be considered.

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Necrotizing Fasciitis of the Parapharyngeal Space with Carotid Artery Occlusion and Acute Hemiplegia

PEDIATRICS ◽

10.1542/peds.73.3.343 ◽

1984 ◽

Vol 73 (3) ◽

pp. 343-347

Author(s):

Janice K. Bush ◽

Laurence B. Givner ◽

Stephen H. Whitaker ◽

Donald C. Anderson ◽

Alan K. Percy

Keyword(s):

Carotid Artery ◽

Necrotizing Fasciitis ◽

Head And Neck ◽

Parapharyngeal Space ◽

Artery Occlusion ◽

Carotid Artery Occlusion ◽

Dental Pathology ◽

Neurologic Sequelae ◽

Focus Of Infection ◽

The Right

Necrotizing fasciitis is characterized by necrosis with extension over fascial planes and mixed aerobic-anaerobic etiologies. Necrotizing fasciitis is uncommon in children and seldom involves the head and neck area. An infant who developed necrotizing fasciitis involving the parapharyngeal space is described. Chronic dental pathology was probably the initial focus of infection. The patient had a left hemiparesis due to a right middle cerebral artery infarct. Carotid angiography demonstrated complete occlusion of the right internal carotid artery, probably secondary to inflammatory arteritis or direct compression along its course through the parapharyngeal space. Mixed aerobic-anaerobic etiologies predominate in infections of the potential spaces of the head and neck as was demonstrated in this patient. The patient recovered, but had neurologic sequelae. Prompt and aggressive therapy is necessary in patients with necrotizing fasciitis syndromes in order to avoid such severe complications.

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Trigeminal Schwannoma Extending Into the Parapharyngeal Space

Journal of Craniofacial Surgery ◽

10.1097/scs.0000000000000593 ◽

2014 ◽

Vol 25 (4) ◽

pp. e328-e330 ◽

Cited By ~ 2

Author(s):

Ali Cemal Yumuşakhuylu ◽

Murat Sari ◽

Muhammet Fatih Topuz ◽

Tekin Bağlam ◽

Adem Binnetoğlu

Keyword(s):

Parapharyngeal Space ◽

Trigeminal Schwannoma

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Orbital extension of trigeminal schwannoma

Journal of Neurosciences in Rural Practice ◽

10.4103/0976-3147.143214 ◽

2015 ◽

Vol 6 (01) ◽

pp. 102-104 ◽

Cited By ~ 3

Author(s):

Shantanu Ghosh ◽

Debabrata Das ◽

Rahul Varshney ◽

Sumit Nandy

Keyword(s):

Surgical Excision ◽

Middle Cranial Fossa ◽

Mri Scan ◽

Nerve Sheath Tumors ◽

Peripheral Nerve Sheath Tumors ◽

Trigeminal Schwannoma ◽

Corrected Visual Acuity ◽

Post Operative Period ◽

Cranial Fossa ◽

The Right

ABSTRACTSchwannomas, also known as neurilemmomas, are benign peripheral nerve sheath tumors. Trigeminal schwannomas are rare intracranial tumors. Here, we report a 35-year-old female presenting with an axial proptosis of right eyeball with right-sided III, IV and VI cranial nerve palsy. Her best corrected visual acuity in the right eye was perception of light absent and in the left eye was 20/20. MRI scan revealed a large right-sided heterogeneous, extra-axial middle cranial fossa mass that extended to the intraconal space of right orbit. A diagnosis of intracranial trigeminal nerve schwannoma with right orbital extension was made. Successful surgical excision of the mass with preservation of the surrounding tissues and orbital exenteration was done. Post-operative period was uneventful.

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