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Management of an incidental malignant peripheral nerve sheath tumour in the parapharyngeal space

Published online by Cambridge University Press:  07 December 2012

E Mushi*
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, University Hospital Aintree, Liverpool, UK
S Winter
Affiliation:
ENT Department, John Radcliffe Hospital, Oxford, UK
*
Address for correspondence: Miss E Mushi, Apartment 36, 3 New Hawthorne Gardens, Liverpool L18 8FE, UK E-mail: eriola.mushi@gmail.com

Abstract

Background:

Parapharyngeal space tumours are uncommon and represent 0.5–1 per cent of all head and neck neoplasms; 20–30 per cent of these are malignant. Malignant peripheral nerve sheath tumours are rare and mostly encountered in patients with neurofibromatosis type 1. Only four cases of parapharyngeal space tumours have been reported in the English language in patients without neurofibromatosis type 1.

Case report:

We report the case of a 64-year-old man with no stigmata of neurofibromatosis type 1, in whom a mass in the left pre-styloid region of the parapharyngeal space was an incidental finding following magnetic resonance imaging for investigation of cervical spine problems. The mass was consequently removed using a transcervical approach. A histological review revealed a low-grade malignant peripheral nerve sheath tumour.

Discussion:

We consider the pathophysiology of this highly malignant tumour as well as the challenging anatomy of the parapharyngeal space and the surgical and other therapeutic modalities utilised to treat this condition.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2012

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