Giant Parapharyngeal Space Pleomorphic Adenoma Causing Acute Airway Obstruction

• Published in: Oman medical journal Vol. 32; no. 3; pp. 240 - 242
• Main Authors: Shirazi , Nadia, Luthra , Mahima, Bist , Sampan S, Agrawal , Vinish
• Format: Journal Article
• Language: English
• Published: Muscat - Oman Oman Medical Specialty Board 01.05.2017; OMJ
• Subjects: ADENOMA; AIRWAY OBSTRUCTION; BENIGN TUMOURS; Case Report; CASE STUDIES; Cytodiagnosis; Neck; Parapharyngeal space; PHARYNX; Pleomorphic; RESPIRATORY DISEASES; Respiratory distress syndrome, Adult; Treatment; Tumors; أمراض التنفس; إنسداد المنفذ الهوائي; الأورام الحميدة; البلعوم; الورم الغدي; دراسات الحالة; Adenoma, Pleomorphic; Airway Obstruction; Parapharyngeal space
• ISSN: 1999-768X; 2070-5204
• DOI: 10.5001/omj.2017.44

Primary parapharyngeal space (PPS) tumors are rare, representing only 0.5% of all head and neck neoplasms. About 80% of tumors of this space are benign, and 20% are malignant. They often pose therapeutic and diagnostic problems due to variable nonspecific symptoms and the complex anatomy of this space. Pleomorphic adenoma is the most common benign tumor of this space. It presents as an asymptomatic mass causing mild bulging in the soft palate or tonsillar region, or fullness near the angle of the mandible in the neck. We report the case of a 60-year-old male admitted to the emergency department with breathing difficulty and acute stridor. He was unable to maintain oxygen saturation, and an emergency tracheostomy was performed. Radiological and cytological evaluation were performed, and the patient was diagnosed as having primary PPS pleomorphic adenoma. The tumor was excised via the transcervical approach. The rarity of tumor in this space and unusual life-threatening presentation prompted the authors to report this case. To our knowledge, this is the third case reported worldwide of a pleomorphic adenoma causing upper airway obstruction and acute respiratory failure.