PMC4896013_01
28-year-old woman with benign, mature, parapharyngeal teratoma. A reformatted coronal post-contrast CTA image demonstrates focal areas of low attenuation representing fat, along with several foci of calcification and soft tissue densities in a left parapharyngeal space mass highly suggestive of a teratoma. The lesion appears to be submucosal thus arising from the parapharyngeal space and no extending from the nasopharynx.
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A coronal computed tomographic angiogram (CTA) demonstrated focal areas of low attenuation representing fat, along with several foci of calcification and soft tissue densities in a left parapharyngeal space mass highly suggestive of a teratoma (Fig. 1A). A mass effect on the oropharynx was noted as well as a posterolateral displacement of the left internal carotid artery, indicating the mass was arising from the prestyloid parapharyngeal space (Fig 1B).
28-year-old woman with benign, mature, parapharyngeal teratoma. Axial CTA with contrast demonstrates a grossly heterogeneous mass with fluid, fat, calcification, and soft tissue densities in the left prestyloid parapharyngeal space. Note the mass effect on the oropharynx, the compression of the internal jugular vein, and the posterolateral displacement of the internal carotid artery.
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The mass demonstrated areas of high and low intensity signals and was found to be independent of the deep lobe of the parotid gland. These findings were also consistent with a benign teratoma (Fig. 2A). A coronal T2 weighted Fast Recovery Fast Spin Echo (FRFSE) sequence also demonstrated a heterogeneous, multiloculated mass with lobules surrounded by a distinct fat plane (Fig. 2B).
28-year-old woman with benign, mature, parapharyngeal teratoma. Coronal T1 weighted MR with contrast and fat saturation demonstrates a well-circumscribed, heterogeneous, multiloculated lesion within the left parapharyngeal space. The mass demonstrates both areas of high and low intensity signals and is independent of the deep lobe of the parotid gland. These findings are consistent with a benign teratoma.
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Sectioning revealed fibrous cut surface with multiple cyst-like structures containing pale tan, gelatinous contents and areas of calcification consistent with a mulitcystic mature teratoma (Fig. 3).