A surgical treatment of cavernous haemangioma in the parapharyngeal space

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  • Maeda Hiroyuki
    Department of Otorhinolaryngology-Head and Neck Surgery Graduate School of Medicine, University of the Ryukyus
  • Touyama Masatomo
    Department of Otorhinolaryngology-Head and Neck Surgery Graduate School of Medicine, University of the Ryukyus
  • Agena Shinya
    Department of Otorhinolaryngology-Head and Neck Surgery Graduate School of Medicine, University of the Ryukyus
  • Matayoshi Sen
    Department of Otorhinolaryngology-Head and Neck Surgery Graduate School of Medicine, University of the Ryukyus
  • Suzuki Mikio
    Department of Otorhinolaryngology-Head and Neck Surgery Graduate School of Medicine, University of the Ryukyus

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Other Title
  • 副咽頭間隙に発生した海綿状血管腫の1手術例

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Cavernous haemangioma commonly occurs at the mucous membrane of the nasal or oral cavity, inside the tongue and on the surface of facial skin in the head and neck region. Tumors occurring in the parapharyngeal space are very rare and we could find only three case reports worldwide. We report in detail our experience of surgical treatment for this rare tumor. <br>The patient was a 66-year-old male. In April 2014, he visited his family doctor because of the symptom of globus pharyngeus. A tumor occupying the right parapharyngeal space was found by MRI imaging, so he was referred to our hospital for further tests. As initial findings, his mesopharyngeal wall was swollen and the postnasal cavity was completely obstructed. However, irregular surface of the swelling wall was not found. In the CT scan and MRI findings, spindle tumor with an obvious capsule was found in the right parapharyngeal space. In the FDG-PET findings, abnormal concentration was not found in the local neck area or any part of his body. From these results, we diagnosed the tumor as a neurogenic tumor （e.g. Schwannoma）, and surgical treatment was performed. The tumor was removed clearly by a combination of the trans-cervical approach and trans-parotid approach. There was little bleeding during the operation and he was in good condition after the operation. However, the tumor was diagnosed as cavernous haemangioma from the pathological findings. Though there was no major bleeding during operation in this case, an accurate pre-operation diagnosis is important because of the high risk of major bleeding during operation.

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