Parapharyngeal lipoma: a case report

Abstract

A 44-years-old male presented with right infraauricular swelling. It had been four months since he was aware of the mass. He had not felt any pain or tenderness. Computed tomograpy demonstrated a homogenous, regular surfaced mass located in the prestyloid and poststyloid parapharyngeal space. Its density was concordant with lipomatous tissue, so it was considered to be an infiltrating parapharyngeal lipoma. Postoperative diagnosis revealed a similar result. We believe that computed tomograpy is an effective method of diagnosing parapharyngeal space tumors and tansparotid approach for this localization is very useful for both preserving facial nerve functions and exposing the mass clearly. We report a case of parapharyngeal lipoma slightly invading the deep lobe of the parotid gland.

Keywords

• Computed tomography, lipoma, neoplasm, parotid, parapharyngeal space, tumor

Parafarengeal lipoma: Olgu sunumu

Abstract

Kırk dört yaşında erkek hasta sağ tarafında kulak altında şişlik yakınması ile kliniğimize başvurdu. Öyküsünden hastanın dört aydır kitlenin farkında olduğu ve her- hangi bir ağrı ya da hassasiyet hissetmediği anlaşıldı. Bilgisayarlı tomografi incelemesinde prestiloid ve post- stiloid parafarengeal mesafeyi tutan, homojen, düzgün yüzeyli bir kitle saptandı. Kitlenin yoğunluğu yağ doku- suyla uyumluydu ve bu yüzden infiltran parafarengeal lipoma olarak değerlendirildi. Ameliyat sonrasındaki patolojik tanı da benzer sonucu gösterdi. İnanıyoruz ki bilgisayarlı tomografi prafarengeal bölge tümörlerinin tanısında oldukça etkili bir yöntemdir ve bu alandaki tümörlerin tedavisinde transparotid yaklaşım hem fasi- al sinir fonksiyonlarının korunmasında hem de kitlenin ekspoze edilmesinde değerli bir yöntemdir. Bu makale- de parotid glandın derin lobunu hafifçe invaze eden bir parafarengeal lipoma olgusu sunuldu

Keywords

• Bilgisayarlı tomografi, lipoma, neoplazma, parotid, parafarengeal alan, tümör

References

1. Rydholm A, Berg NO. Size, site and clinical incidence of lipoma. Factors in the differential diagnosis of lipo- ma and sarcoma. Acta Orthop Scand 1983;54:929-34.
2. Batsakis JG, Sneige N. Parapharyngeal and retropha- ryngeal space diseases. Ann Otol Rhinol Laryngol 1989;98:320-1.
3. Work WP, Hybels RL. A study of tumors of the parapharyngeal space. Laryngoscope 1974;84:1748-55.
4. Janecka IP, Conley J, Perzin KH, Pitman G. Lipomas presenting as parotid tumors. Laryngoscope 1977; 87:1007-10.
5. Weiner GM, Pahor AL. Deep lobe parotid lipoma: a case report. J Laryngol Otol 1995;109:772-3.
6. Kimura Y, Ishikawa N, Goutsu K, Kitamura K, Kishimoto S. Lipoma in the deep lobe of the parot- id gland: a case report. Auris Nasus Larynx 2002; 29:391-3.
7. Ulku CH, Uyar Y, Unaldi D. Management of lipomas arising from deep lobe of the parotid gland. Auris Nasus Larynx 2005;32:49-53.
8. Ahuja AT, King AD, Kew J, King W, Metreweli C. Head and neck lipomas: sonographic appearance. AJNR Am J Neuroradiol 1998;19:505-8.

9. Murphey MD, Carroll JF, Flemming DJ, Pope TL, Gannon FH, Kransdorf MJ. From the archives of the AFIP: benign musculoskeletal lipomatous lesions. Radiographics 2004;24:1433-66.
10. Kransdorf MJ, Moser RP Jr, Meis JM, Meyer CA. Fat-containing soft-tissue masses of the extremities. Radiographics 1991;11:81-106.
11. Kransdorf MJ, Bancroft LW, Peterson JJ, Murphey MD, Foster WC, Temple HT. Imaging of fatty tumors: distinction of lipoma and well-differentiated liposar- coma. Radiology 2002;224:99-104.
12. Ha TV, Kleinman PK, Fraire A, Spevak MR, Nimkin K, Cohen IT, et al. MR imaging of benign fatty tumors in children: report of four cases and review of the litera- ture. Skeletal Radiol 1994;23:361-7.
13. Ohguri T, Aoki T, Hisaoka M, Watanabe H, Nakamura K, Hashimoto H, et al. Differential diagnosis of benign peripheral lipoma from well-differentiated liposar- coma on MR imaging: is comparison of margins and internal characteristics useful? AJR Am J Roentgenol 2003;180:1689-94.
14. Layfield LJ, Glasgow BJ, Goldstein N, Lufkin R. Lipomatous lesions of the parotid gland. Potential pit- falls in fine needle aspiration biopsy diagnosis. Acta Cytol 1991;35:553-6.
15. Miller FR, Wanamaker JR, Lavertu P, Wood BG. Magnetic resonance imaging and the management of parapharyn- geal space tumors. Head Neck 1996;18:67-77.
16. Bass RM. Approaches to the diagnosis and treatment of tumors of the parapharyngeal space. Head Neck Surg 1982;4:281-9.