副咽頭間隙の巨大嚢胞形成を伴う多形腺腫例

Abstract

The patient was an 82-year-old female with a swelling at the left side of the soft palate. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a large cystic tumor in the left parapharyngeal space. The cystic tumor was removed via a cervical approach with mandibulotomy (mandibular swing approach). Postoperative histological examination revealed a pleomorphic adenoma with cystic formation.Pleomorphic adenoma with large cystic formation is rare in the parapharyngeal space and a differential diagnosis includes branchial cleft cyst, abcess, cystic hygroma, metastatic lymph node with central necrosis and aneurysm. CT and MRI are essential for diagnosis and provide information on the size and location of the tumor. There are several possible approaches to tumors in the parapharyngeal space: transoral excision, cervical approach with or without mandibulotomy and transparotid approach. It is preferable to perform a mandibular swing approach for the removal of the large tumor in the parapharyngeal space.