CASE REPORTS   

Otorinolaringologia 2004 September;54(3):169-74

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: Italian

Parapharyngeal space neoplasms. Two interesting case reports

Rizzo S., Strinati F., Bizzotti C., Bernardini M., Longari F., Bracchi E., Frenguelli A.

Clinica Otorinolaringoiatrica R Dipartimento delle Specialità Medico-Chirurgiche Università degli Studi di Perugia Azienda Ospedaliera «S. Maria», Terni

Primitive or secondary neoplasms arising from parapharyngeal space are not easy problems from the diagnostic and therapeutic points of view, due to the anatomic complexity of that area. In literature, the data for these pathologies are poor and also scarce are wide clinical reviews that would help to understand rare pathologies like that of the parapharyngeal space. The symptomatology is generally late and poor, the neoplasm, during its growth, induces non specific symptoms such dysphonia, dyspnea, pharyngeal and tongue paresthesias, tubaric dysfunction with transmissive hearing loss. Imaging, CT and NMR with or without angiographic scanning, are the most important instruments for the diagnosis of these pathologies. In all cases, surgery is the elective therapy with the purpose to remove completely the neoplasm. Prognosis of benign neoplasms is generally good, while in malignant cases it is fatal, due to diagnostic delay. The authors present 2 clinical cases: a hemangiopericytoma in a young female patient and a metastatic amelanotic melanoma of a male patient, who died 6 months after the diagnosis due to metastatic spreading. The 2 cases reported emphasize that a diligent and correct diagnostic iter and a radical surgical therapy are necessary for the right treatment of parapharyngeal neoplasm, insidious pathologies with a high grade of relapses, expecially in malignant forms.