PMC6020505_01
The oropharyngeal lumen is narrowed by a mass in the left parapharyngeal space. A small area of fibrin is visible at a previous puncture point (arrow).
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fig1
The contrast-enhanced axial CT scan shows the nonhomogeneous tumor within the left parapharyngeal space with a narrowing pharyngeal lumen (arrow). Note the normal fat contour in the right prestyloid compartment (asterisk).
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fig2
(a) Magnetic resonance imaging, axial projection. A large mass with cystic degeneration (asterisk) dislocating the root of the tongue is seen in the left parapharyngeal space. Stretched pterygoid muscles are shown with arrows. (b) Coronal projection shows the limits of the tumor (upper: the skull base; lower: the level of the submandibular salivary gland). Double arrow shows the laterally dislocated third branch of the trigeminal nerve on the left side. Note the normal proximal segment of the V3 on the right side (thin arrow).
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fig3
Deformed from the medial part, the lateral pterygoid muscle with the V3 is shown in Figure 3.
An angiographic study showed the tumor contour and contrasted tumor-feeding blood vessels:the ascending pharyngeal artery was the main vessel.
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fig4
During an angiographic study prior to the surgery, the tumor-feeding blood vessels, of which the main vessel was the left ascending pharyngeal artery, were identified and embolized (Figure 4).
Histopathology showing monomorphic spindle cells with oval nuclei and eosinophilic cytoplasm positive for S100 calcium-binding protein P. The tumor cells formed palisade structures.
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fig5
(a) Normal contour of the oropharynx six months postoperatively. (b) Computed tomography axial image: no tumor relapse is seen.
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fig6