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Official Journal of the Italian Society of Maxillofacial Surgery
Caldarelli C. 1, Farri F. 2, Bucolo S. 1, Farri A. 3
1 Department of ENT and Maxillo-Facial Surgery, ASLTO2 Torino Emergenza Nord, Ospedale San Giovanni Bosco, Turin, Italy;
2 Department of ENT, AOU Molinette San Giovanni Battista, University of Turin, Turin, Italy;
3 Department of ENT, AOU Ospedale Maggiore della Carità, Novara, Italy
Tumors of the parapharyngeal space still represent a challenge to surgeon for presumptive diagnosis and surgical treatment. The frequent lack of preoperative cytology makes diagnosis of nature uncommon prior to surgery. The important volume they can reach, their silent character and the complex anatomy of this very deep area in the neck make surgical removal difficult also for benign tumors. This report describes two cases of pleomorphic adenoma arising from the deep lobe of the parotid gland presented like a parapharyngeal mass at MRI or neck CT-scan. One of them appeared as a “dumb-bell” shaped tumor in the prestyloid space while the other presented as a mass located between distal internal and external carotid arteries near to the skull base. In the latter case a three dimensional angio-CT better cleared the relationships between tumor and carotid walls. Complete removal of both tumors was performed by a transcervical/transparotid approach simple or combined with paramedian mandibulotomy in the patient suspected for carotid involvement.