Journal of Regional Section of Serbian Medical Association in Zajecar

Year 2008     Volumen 33     Number 1-2
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UDK 616.321-006 ISSN 0350-2899, 33(2008) br.1-2 p.45-51
Case report

Asymptomatic expansive parapharyngeal space tumour as incidental endocranial MRI finding

Goran Bjelogrlić(1), Milovan Dimitrijević(1),Vesna Stojanović Kamberović(2),
Goran Videnović(3)




INTRODUCTION: The parapharyngeal space tumour, benign, primary malignant or metastatic in its nature and predominantly unilaterally localised may originate from all the regional elements and its characteristic symptoms depend on size, localisation and expansion degree. AIM: to review an asymptomatic tumour in the parapharyngeal space incidentally detected upon MRI performed for neuroophthalmologic reasons. METHOD: the information needed for the case report is obtained by means of anamnesis, clinical examination, splanchnocranial MRI, neck echo examination, intraoperative findings and PH analysis of the extirpated tumour. RESULTS: a 62-year old female patient came for check-up in 2007 due to tumour formation in the parapharyngeal space that was detected upon endocranial MRI within the diagnosis of the transitory ischemic attack. The expansive formation of irregular ellipsoid shape, sized 52 x 52 x 33 mm compressing the right lateral epipharyngeal and oropharyngeal wall was evidenced in the right parapharyngeal space, medially to the mandibular ramus, with relatively benign MRI characteristics. The obtained history was negative, without any symptoms typical for tumour change in the parapharyngeal space. Clinical examination evidenced lowering of the anterior and posterior palatine arches on the right side as well as their medial dislocation with anterior uvular dislodgement. Intraoral palpation evidenced a lobular, painless, poorly demarcated tumour change in the region of the right, anterior palatine arch. The patient was surgically treated at the Institute of ENT and MFS, CCS Belgrade in January 2008 using external cervical and transoral approach. Parapharyngeal space was accessed and identified tumour change sized 4 x 5 cm was prepared to be completely extirpated and referred to PH analysis (pleomorphic adenoma). CONCLUSION: Pleomorphic adenoma, benign epithelial tumour of asymptomatic course, liable to recurring, with low incidence of malignant alteration, was detected owing to the destruction of the surrounding structures due to its extensive growth producing the symptoms dependent on localisation, however it is frequently detected incidentally upon diagnostic procedures performed for other reasons.
Key words: MRI, asymptomatic tumour, parapharyngeal space

: kompletan tekst rada na srpskom jeziku
Note: full text in Serbian
  Corresponding Address:
Goran Bjelogrlić
Institut za ORLi MHF, KCS, Beograd
Pasterova br.2, 11000 Beograd
e-mail: masagoran@ptt.yu   

Paper received: 30.12.2007
Paper accepted: 16.9.2008
Published online: 20.10.2008
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