PMC7339072_01
Nasopharyngoscopic examination of the oropharynx and direct examination of the oral
cavity revealed a mass in the left soft palate. (a) Swelling of the pharyngeal orifice
of Eustachian tube and (b) a mass in the left soft palate.
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Nasopharyngoscopic examination showed prominence in the left pharyngeal wall near the pharyngeal orifice of Eustachian tube (Figure 1).
MRI before the operation showed the well-defined mass in the left PPS: (a) axial
Gd-enhanced T1-weighted, (b) sagittal Gd-enhanced T1-weighted, and (c) axial
T2-weighted.
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Signal intensity was mostly high on T2-weighted imaging, but with a few areas of low signal intensity (Figure 2).
Surgical view. We could clearly visualize the tumor using a flexible-tipped rigid
endoscope (deflectable-tip ENDOEYE; OLYMPUS LTF-S190-5(R), Tokyo, Japan). (a) A
vertical mucosal incision was made in the soft palate; (b) the constrictor muscle of the
pharynx was cut, and the surface of the tumor capsule was exposed; (c) the tumor was
separated from the medial pterygoid muscle and the tissue behind the hard palate; (d)
the tumor was completely excised; (e) the wound after the excision; and (f) the wound
was sutured. u: uvula.. *The medial pterygoid muscle.. **The tensor veli palatini muscle.
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An assistant maintained a view of the pharynx using a deflectable-tip ENDOEYE (OLYMPUS LTF-S190-5(R), Tokyo, Japan) (Figure 3).
The resected specimen was soft and elastic. Results from histopathological examination:
cavernous hemangioma. (a) Hematoxylin and eosin (HE) staining. The extended venous
cavity is surrounded by a single layer of vascular endothelial cells. (b) Elastica van
Gieson (EVG) staining: elastic fibers stain black-purple, indicating blood vessels.
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The resected specimen was soft and spongy (Figure 4). Histopathological examination demonstrated VM (Figure 4).