van Hees T, et al. - Authors sought to assess the clinical course and management of parapharyngeal space (PPS) tumors in this series of 99 PPS tumors. It was noted that in these specific and rare group of head and neck tumors, a careful diagnostic workup and proper surgical planning were important. In (56%) of parapharyngeal tumors surgery was seen to be the main treatment. Due to peri-operative risk for permanent cranial nerve damage, management of parapharyngeal neurogenic neoplasms generally consisted of active surveillance. Findings revealed consistent histopathological diagnoses with previous reports.

Methods

• The clinical data from cases treated for PPS tumors from 1991 to 2012 (warranting at least a 4-year follow-up) at the VU University Medical Center, Amsterdam, The Netherlands were included in this retrospective study.

Results

• The experts noted that 50% tumors were salivary gland tumors, 41% were neurogenic and 9% had a different origin.
• In the PPS tumors 18.2% were malignant.
• Swelling of the neck and throat was the most commonly reported symptom at presentation.
• The PPS tumor was an accidental finding after imaging for other diagnostic reasons in 14% of the cases.
• An accuracy rate of 73.1% (19/26) was noted in the cytology.
• Results demonstrated that the positive predictive value of a malignant cytology result was 86% (95% CI 42.1–99.6%).
• In 55 patients (56%) surgery was conducted.
• The cervical–transparotid approach was the most commonly performed approach (56%), followed by the cervical (25%), transmandibular (16%) and transoral (2%) approach.
• They noted that 9 patients died of the disease.
• Among the death reported cases, 7 patients had malignant salivary gland tumor, 1 patient had a pleomorphic adenoma at first diagnosis that degenerated into carcinoma ex pleomorphic adenoma and 1 patient died because of metastatic renal cell carcinoma.