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Transoral examination of the oropharynx showing an extensive bulging of the lateral pharyngeal wall (white star)
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ENT colleague who discovered a bulging of the left tonsillar fossa and lateral pharyngeal wall. Examination of the oropharynx revealed a firm submucosal mass of the parapharyngeal space extending from the lower one-third of the nasopharynx to the lower aspect of the tonsillar fossa (Figure 1).
Sagittal (A) and coronal (B) MRI sections (T1-sequences) of the upper airways. The images show a homogenous parapharyngeal mass adjacent to the masticator space laterally, extending to the retropharyngeal and carotid space dorsally. The mass is narrowing the upper airways at the level of the oropharynx. There are no signs of malignancy. (C) Resected specimen of the well-defined and encapsulated (histologically confirmed) lipoma
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T2-weighted sequences (Figure 2A,B). The mass extended beyond the midline to the right side and caused stenosis of the upper airway with no neck lymphadenopathies. The radiological pictures highly suggested the presence of a large lipoma of the parapharynx. A complete surgical excision of the mass was performed (Figure 2C) using a transoral approach.