Parapharyngeal space tumors: A 10 year experience of IPO-LFG
DOI:
https://doi.org/10.34631/sporl.291Keywords:
Parapharyngeal space tumors, head and neck tumorsAbstract
Introduction: Parapharyngeal space neoplasms are rare, accounting for only 0.5% of head and neck tumors. The majority of PPS tumors are benign, but a wide spectrum of pathologies, both benign and malignant, has been encountered in this region. This range of histopathologies in combination with the complex anatomy of the parapharyngeal space creates complex diagnostic and management challenges.
Objective: To describe and analyze a case series of primary parapharyngeal space neoplasms at Instituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG).
Methods: Retrospective review of medical records of patients with parapharyngeal space neoplasms, diagnosed or referred to IPOLFG between 1st of January of 2003 and 31st of December of 2013. Results: 38 patients were included. The median age was 52 years (Interquartile range 40-63). 10 patients (26.3%) were asymptomatic. The most common symptom was an oropharyngeal lump sensation (23.7%). All patients had preoperative imaging: 94.7% computed tomography and 68.4% magnetic resonance image. 39.5% underwent fineneedle aspiration biopsy. 31 tumors were benign (81.6%), with pleomorphic adenomas comprising the majority (58.1%). 7 were malignant (18.4%), with carcinoma ex pleomorphic adenoma (28.6%) and lymphoma (28.6%) being the most common. 36 patients (94.7%) underwent primary surgical management; the other 2 patients (5,3%) were treated with chemotherapy and chemoradiotherapy, respectively. The cervical approach was the most common (80%). A mandibulotomy was required in just 5.7% of primary cases. The most frequent complication was cranial neuropathy, identified in 22,2%. Of these, 75% were sequelae from resection of neurogenic tumors. Median follow-up was 6.5 years.
Conclusion: PPS tumors require a high index of suspicion to diagnose them at an early stage. Complete surgical resection is the mainstay of treatment. The optimum surgical approach needs to be selected on an individual basis, but the cervical approach is safe and effective for most PPS neoplasms.
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