Cases reported "Pharyngeal Neoplasms"

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1/106. A new transfacial approach for lesions of the clivus and parapharyngeal space: the partial segmented Le Fort I osteotomy.

    Tumors of the clival and parapharyngeal areas are a challenge because of their location. They used to be considered inaccessible because the aggressive approaches employed caused elevated levels of morbidity. This fact led to more conservative approaches that attempted to preserve the exposure of the lesion. These approaches were a combination of cranial and facial procedures, thus utilizing a combined effort between neurosurgeons and maxillofacial surgeons. We described our experience with a partial segmented Le Fort I osteotomy added to a transmandibular approach to expose a chordoma of the clivus and left parapharyngeal space. A three-dimensional imaging was used as a diagnostic tool and to plan the optimal surgical approach. The operative technique was described in this case study. Some important technical details of the approach are described. The global outcome was favorable.
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2/106. Synovial sarcoma in the parapharyngeal space: case report and review of the literature.

    We encountered a rare case of synovial sarcoma in the parapharynx of a 47-year-old Japanese man. This patient presented with an enlarging tumor in the right side of his neck that had grown progressively over a 4-week period. Radiological examinations revealed that the tumor arose from the parapharyngeal space. The tumor could not be completely removed at surgery. Metastasis to the lumbar vertebra was detected postoperatively. The patient underwent three courses of chemotherapy and the delivery of palliative radiation to the lumbar vertebra without success. The patient died of lung metastasis 7 months after surgery.
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3/106. Case report: extranodal non-Hodgkin's lymphoma of the parapharyngeal space.

    We report an unusual case of primary extranodal non-Hodgkin's lymphoma of the parapharyngeal space. Clinical presentation looked like right peritonsillar abscess and hypoglossal palsy. After histologic study of his biopsy, this 19-year-old man was given a diagnosis of diffuse large-cell non-Hodgkin's lymphoma. Immunohistochemical study showed cell-type B and he was determined to have Stage IIE. Treatment combined chemotherapy and radiotherapy. Extranodal lymphoma of the head and neck presents a diagnostic problem. We review various approaches to extranodal non-Hodgkin's lymphomas of the head and neck. This condition especially requires communication between the surgeon and the pathologist, essential in preventing an incorrect or delayed diagnosis.
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4/106. leiomyoma of the parapharyngeal space.

    A rare case of leiomyoma of the prestyloid parapharyngeal space is reported together with computed tomographic and magnetic resonance imaging findings. The tumor appeared as a well-circumscribed ovoid mass with some calcifications and lobulations. Because the attenuation, signal intensity, and shape of the mass were not specific and were similar to those of a pleomorhic adenoma, the most common tumor of the prestyloid parapharyngeal space, radiological differentiation of leiomyoma from pleomorphic adenoma of the prestyloid parapharyngeal space was difficult.
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5/106. Cemento-ossifying fibroma presenting as a mass of the parapharyngeal and masticator space.

    We report a case of cemento-ossifying fibroma that presented as a large extraosseous mass in the masticator and parapharyngeal space. CT scanning and MR imaging showed a large extraosseous mass with central conglomerated, well-matured ossified nodules and fatty marrow. The central matured ossified nodules were of low density on CT scans and high signal intensity on T1- and T2-weighted MR images. Multiplanar reformatted CT scans revealed the origin of the mass to be at the extraction site of the right lower second molar tooth.
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6/106. Parapharyngeal space mesenchymal chondrosarcoma in childhood.

    A case of extra osseous mesenchymal chondrosarcoma occuring in the parapharyngeal space in a 7-year-old girl, is being presented for its rarity. It is a slow growing, locally aggressive tumour with a high incidence of local recurrence as well as distant metastasis. It is rare in the pediatric age group and rarer in the parapharyngeal space. It has a poor prognosis, the 5-year survival rate varies between 30 and 50%. Radical surgery is the treatment of choice. radiotherapy and chemotherapy have an adjuvant role. More experience with this tumour is required to evaluate the most effective treatment. Current literature on this subject has been reviewed.
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7/106. Hyalinizing spindle cell tumor with giant rosettes--a soft tissue tumor with mesenchymal and neuroendocrine features. An immunohistochemical, ultrastructural, and cytogenetic analysis.

    CONTEXT: Hyalinizing spindle cell tumor with giant rosettes is a recently described biphasic neoplasm of soft tissues that shares mesenchymal and neuroendocrine features. Its morphologic structure is distinctive, with the presence of hyalinized paucicellular foci that are termed rosettes. The cells around the latter display positive immunoreactivity for neuroendocrine markers. The small number of cases described to date indicates that they tend to be localized in the extremities. OBJECTIVE: To describe the clinicopathologic features of 2 unusual cases of hyalinizing spindle cell tumor with giant rosettes. methods AND RESULTS: One tumor was located in the prestyloid parapharyngeal space and the second in the left thigh. Both tumors were well circumscribed and surrounded by a thin capsule-like fibrous band without infiltrating projections. The rosettes were embedded in a spindle cell proliferation. Immunohistochemical stains showed positive results for S100 protein, synaptophysin, CD57, protein gene product 9.5, and neuron-specific enolase exclusively in the cells palisading the rosettes. These markers were negative in the spindle cell portions of the tumor. The latter were immunoreactive for factor xiiia, vimentin, HAM56, collagen IV, and CD68. vimentin was the only marker shared by the rosette-forming cells and the spindle cells. Ultrastructurally, the rosette-forming cells contained neurosecretory granules. This study describes the first cytogenetic analysis in this type of tumor revealing 2 cell lines, both containing a balanced translocation between chromosomes 7 and 16. Follow-up of the patients at 16 and 8 months did not disclose evidence of recurrence. CONCLUSIONS: These 2 new cases increase the awareness of hyalinizing spindle cell tumor with giant rosettes and demonstrate that it is a spindle cell neoplasm of unique cytogenetic rearrangements composed of dendritic, histiocytic, and fibroblastic cells admixed with cells that have neuroendocrine differentiation.
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8/106. Pleomorphic adenoma of the retropharyngeal space: a rare location.

    A case of an isolated pleomorphic adenoma of the retropharyngeal space is reported, this has not been documented previously in the literature. attention is drawn to the wide spectrum of benign and malignant neoplasms that can potentially occur within this complex anatomical region. The importance of a systematic and logical approach to the management of such lesions is emphasized.
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9/106. chylothorax complicating radical neck dissection.

    The third reported instance of chylothorax occurring after left radical neck dissection is presented and the literature reviewed. The pathogenesis appears to be lymphatic leakage in the neck with accumulation of chyle in the pleural space in spite of the absence of pneumothorax. The means for entry across an intact pleura is uncertain. The condition can be managed by conservative means consisting of adequate neck drainage and thoracentesis or chest tube drainage. A favorable outcome can be expected.
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10/106. Parapharyngeal second branchial cyst manifesting as cranial nerve palsies: MR findings.

    SUMMARY: We report the MR findings of parapharyngeal branchial cleft cyst manifesting as multiple, lower cranial nerve palsies in a 35-year-old woman. On MR images, a well-marginated cystic mass was detected in the right parapharyngeal space, with displacement of both the right internal carotid artery and the right internal jugular vein on the posterolateral side. The cyst contained a whitish fluid that was slightly hyperintense on T1-weighted images and slightly hypointense to CSF on T2-weighted images. No enhancement on contrast-enhanced T1-weighted images was present. The right side of the tongue showed high signal intensity on T2-weighted images, suggesting denervation.
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