J Korean Assoc Oral Maxillofac Surg.  2024 Feb;50(1):56-59. 10.5125/jkaoms.2024.50.1.56.

Diagnostic and management challenge of concurrent tongue squamous cell carcinoma with an unknown parapharyngeal mass

• Shupak R
• Kim R
• Huh JH

• KMID: 2553663
• DOI: http://doi.org/10.5125/jkaoms.2024.50.1.56

Abstract

There are very few case reports of the diagnosis and management of concurrent oral cavity and parapharyngeal space tumors. We present a case involving a 49-year-old female who presented with oral cavity squamous cell carcinoma confirmed by biopsy. Initial diagnostic workup revealed a concurrent parapharyngeal mass. Diagnostic studies and surgical therapy were tailored to account for both pathological entities. The patient was treated with a combination of surgery and adjuvant therapy. The surgical strategy was designed to address both lesions simultaneously. One year post-surgery, the patient had good response to therapy with no evidence of persistent or recurrent disease. This report discusses the outcome and treatment of a rare case of concurrent squamous cell carcinoma with a complicating parapharyngeal space tumor. It explores the diagnostic process, comprehensive workup, and the surgical management.

Keyword

Parapharyngeal space; Squamous cell carcinoma; Head and neck neoplasms; Mass; Oral cancer

Figure

• 

  Fig. 1 Computed tomography neck with contrast. Dental amalgam obscuring the concomitant parapharyngeal space tumor.

• 

  Fig. 2 T2-weighted magnetic resonance imaging demonstrating a right sided parapharyngeal space tumor.

• 

  Fig. 3 Intraoperative view of the lip-split mandibulotomy and access to the right parapharyngeal space following resection of both primary lesions.

Reference

References

1. Strohl MP, El-Sayed IH. 2019; Contemporary management of parapharyngeal tumors. Curr Oncol Rep. 21:103. https://doi.org/10.1007/s11912-019-0853-8. DOI: 10.1007/s11912-019-0853-8. PMID: 31728649.

2. Mendenhall WM, Strojan P, Beitler JJ, Langendijk JA, Suarez C, Lee AW, et al. 2019; Radiotherapy for parapharyngeal space tumors. Am J Otolaryngol. 40:289–91. https://doi.org/10.1016/j.amjoto.2018.12.010. DOI: 10.1016/j.amjoto.2018.12.010. PMID: 30621929.

3. Bulut OC, Giger R, Alwagdani A, Aldabal N, Stenzinger A, Heimgartner S, et al. 2021; Primary neoplasms of the parapharyngeal space: diagnostic and therapeutic pearls and pitfalls. Eur Arch Otorhinolaryngol. 278:4933–41. https://doi.org/10.1007/s00405-021-06718-4. DOI: 10.1007/s00405-021-06718-4. PMID: 33740083. PMCID: PMC8553685.

4. Matsuki T, Miura K, Tada Y, Masubuchi T, Fushimi C, Kanno C, et al. 2019; Classification of tumors by imaging diagnosis and preoperative fine-needle aspiration cytology in 120 patients with tumors in the parapharyngeal space. Head Neck. 41:1277–81. https://doi.org/10.1002/hed.25552. DOI: 10.1002/hed.25552. PMID: 30620436.

5. Moore MG, Netterville JL, Mendenhall WM, Isaacson B, Nussenbaum B. 2016; Head and neck paragangliomas: an update on evaluation and management. Otolaryngol Head Neck Surg. 154:597–605. https://doi.org/10.1177/0194599815627667. DOI: 10.1177/0194599815627667. PMID: 26861230.