Parapharyngeal Space Tumors of Parotid Origin: Two Case Reports and Review of the Literature

Background and Aim: Tumors of the parapharyngeal space are of special interest because they are rare, with an unusual clinical presentation and demanding surgical approach. The aim of this presentation is to present two interesting cases of parapharyngeal space tumors, arising from the parotid gland, that were diagnosed and treated in our department in the last 12 months. Case Reports: The first patient was a 60-year-old man presenting with a left-sided, smooth, round neck mass in the angle of the mandible. The second one was a 55-year-old woman presenting with unilateral serous otitis media. Both patients were clinically examined and evaluated with CT and MRI. In both cases, an FNAB was obtained transorally. The diagnosis was that of parapharyngeal space salivary tumors. Both patients were operated on through a cervical incision, with identification of the facial nerve and without parotidectomy or mandibulotomy. The tumors were completely and uneventfully excised in both cases. There were no complications, and the patients were dismissed the fourth postoperative day. Conclusion: Tumors restricted to the parapharyngeal space represent a low percentage of neck tumors. Those of salivary gland origin are the most common, but miscellaneous other tumors may occur in this area. Their diagnosis is often delayed because they usually present with signs only after they have reached a substantial size. Surgery is the mainstay of treatment in most cases, for both diagnostic and therapeutic reasons. Care should be taken not to harm important adjacent neural or vascular structures.