Management of parapharyngeal space tumors at the National Cancer Institute, Egypt

J Egypt Natl Canc Inst. 2004 Mar;16(1):34-42.

Abstract

Purpose: The purpose of this study is to evaluate parapharyngeal space (PPS) tumors as regards clinicopathological features, preoperative assessment, different surgical approaches, perioperative complications, patterns of recurrence and the role of non-surgical treatment.

Materials and methods: This study included twenty-five patients with (PPS) tumors presented to NCI, Cairo University, from October 2001 to March 2003. The data of each patient included age, sex, presenting symptoms and signs, provisional diagnosis, preoperative investigations, operative data, histopathological examination, non-surgical treatment and state of follow up. All were collected and analyzed.

Results: This study included 12 males and 13 females. The mean age was 37.1 years. The main presenting symptom and sign was neck swelling. All patients were subjected to CT scan, while 9 patients had MRI. Nineteen patients underwent fine needle aspiration cytology (FNAC) which was conclusive in only 16 patients. Benign lesions were found in 12 patients (48%) and malignant lesions in 13 patients (52%). Parotid gland tumors (40%) and neurogenic tumors (16%) were the commonest. Surgical excision was done in 22 cases. There was no postoperative mortality and overall postoperative morbidity was 9% (2/22). Eight patients received postoperative radiotherapy. Three patients with lymphoma were treated with chemotherapy and two of them received involved field radiotherapy to the Waldyer's ring region. On follow up to 12-30 months, there were only one local and two distant recurrences in the malignant group.

Conclusion: Surgery is the mainstay treatment for tumors of the (PPS). The addition of postoperative radiotherapy in certain indications in malignant tumors of the (PPS) will improve the local control.