Hostname: page-component-848d4c4894-4hhp2 Total loading time: 0 Render date: 2024-06-04T20:32:47.440Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  07 December 2012

E Mushi  and
S Winter
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
Get access Rights & Permissions [Opens in a new window]

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.

Keywords

Parapharyngeal SpacePeripheral Nerve Sheath TumorsSurgical ExposureHistologyNeurofibromatosis
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 1 , January 2013 , pp. 104 - 106
Copyright
Copyright © JLO (1984) Limited 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Allison, RS, Van der Waal, I, Snow, GB. Parapharyngeal tumours: a review of 23 cases. Clin Otolaryngol 1989;14:199–203 CrossRefGoogle ScholarPubMed
2 Carrau, RL, Myers, EN, Johnson, JT. Management of tumours arising in the parapharyngeal space. Laryngoscope 1990;100:583–9CrossRefGoogle ScholarPubMed
3 al-Otieschan, AA, Saleem, M, Manohar, MB, Larson, S, Atallah, A. Malignant schwannoma of the parapharyngeal space. J Laryngol Otol 1998;112:883–7CrossRefGoogle ScholarPubMed
4 Lee, JH, Lee, HK, Choi, CG, Suh, DC, Lee, KS, Khang, SK. Malignant peripheral nerve sheath tumor in the parapharyngeal space: tumor spread through the eustachian tube. AJNR Am J Neuroradiol 2001;22:748–50Google ScholarPubMed
5 Weber, AL, Montandon, C, Robson, CD. Neurogenic tumors of the neck. Rad Clin North Am 2000;38:1077–90CrossRefGoogle ScholarPubMed
6 Bailet, JW, Abemayor, E, Andrews, JC, Rowland, JP, Fu, YS, Dawson, DE. Malignant nerve sheath tumors of the head and neck: a combined experience from two university hospitals. Laryngoscope 1991;101:1044–9CrossRefGoogle ScholarPubMed
7 Woodruff, JM, Selig, AM, Crowley, K, Allen, PW. Schwannoma (neurilemmoma) with malignant transformation. A rare, distinctive peripheral nerve tumor. Am J Surg Pathol 1994;18:882–9CrossRefGoogle ScholarPubMed
8 Shin, JH, Lee, HK, Kim, SY, Choi, CG, Suh, DC. Imaging of parapharyngeal space lesions: focus on the prestyloid compartment. AJR Am J Roentgenol 2001;177:1465–70CrossRefGoogle ScholarPubMed
9 Eisele, DE, Netterville, JL, Hoffman, HT, Gantz, BJ. Parapharyngeal space masses. Head Neck 1999;21:154–93.0.CO;2-W>CrossRefGoogle ScholarPubMed
10 Shin, JH, Lee, HK, Kim, SY, Khang, SK, Park, SH, Choi, CG et al. Castleman's disease in the retropharyngeal space: CT and MR imaging findings. AJNR Am J Neuroradiol 2000;21:1337–9Google ScholarPubMed
11 Pilvaki, M, Chourmouzi, D, Kiziridou, A, Skordalaki, A, Zarampoukas, T, Drevelengas, A. Imaging of peripheral nerve sheath tumors with pathologic correlation: pictorial review. Eur J Radiol 2004;52:229–39CrossRefGoogle Scholar
12 Fernández Ferro, M, Fernández Sanroman, J, Costas López, A, Sandoval Gutiérrez, JS, López de Sanchez, AL. Surgical treatment of benign parapharyngeal space tumours. Presentation of two clinical cases and revision of the literature. Med Oral Patol Oral Cir Bucal 2008;13:61–4Google ScholarPubMed
13 Kar, M, Deo, SV, Shukla, NK, Malik, A, DattaGupta, S, Mohanti, BK et al. Malignant peripheral nerve sheath tumors (MPNST) – clinicopathological study and treatment outcome of twenty-four cases. World J Surg Oncol 2006;4:55CrossRefGoogle ScholarPubMed
14 Ferner, RE, Gutmann, DH. International consensus statement on malignant peripheral nerve sheath tumors in neurofibromatosis. Cancer Res 2002;62:1573–7Google ScholarPubMed
15 Basso-Ricci, S. Therapy of malignant schwannomas: usefulness of an integrated radiologic. Surgical therapy. J Neurosurg Sci 1989;33:253–7Google ScholarPubMed
16 Hruban, RH, Shiu, MH, Senie, RT, Woodruff, JM. Malignant peripheral nerve sheath tumors of the buttock and lower extremity. A study of 43 cases. Cancer 1990;66:1253–653.0.CO;2-R>CrossRefGoogle ScholarPubMed
17 Kourea, HP, Bilsky, MH, Leung, DH, Lewis, JJ, Woodruff, JM. Subdiaphragmatic and intrathoracic paraspinal malignant peripheral nerve sheath tumors: a clinicopathologic study of 25 patients and 26 tumors. Cancer 1998;82:2191–2033.0.CO;2-P>CrossRefGoogle ScholarPubMed
18 Wong, WW, Hirose, T, Scheithauer, BW, Schild, SE, Gunderson, LL. Malignant peripheral nerve sheath tumor: analysis of treatment outcome. Int J Radiat Oncol Biol Phys 1998;42:351–60CrossRefGoogle ScholarPubMed
19 Carli, M, Ferrari, A, Mattke, A, Zanetti, I, Casanova, M, Bisogno, G et al. Pediatric malignant peripheral nerve sheath tumor: the Italian and German soft tissue sarcoma cooperative group. J Clin Oncol 2005;23:8422–30CrossRefGoogle ScholarPubMed