A Case of Neurilemmoma in the Parapharyngeal Space which was Difficult to Differentiate from a Parotid Gland Tumor

Abstract

We report a case of a neurilemmoma in the parapharyngeal space, and describe some valuable information concerning its preoperative diagnosis. A 71-year-old man who had a painless mass in the left cheek region was found to have another tumor in the right cervical region. MRI showed that the tumor had shifted the common carotid artery ventrally and the jugular vein anterolaterally; we hypothesized that the tumor originated from either the deep lobe of the parotid gland or from a cervical nerve. Clinical diagnosis was pleomorphic adenoma of the parotid gland or neurilemmoma of some cervical nerve. We exposed the tumor under general anesthesia. Histopathological diagnosis was Antoni A and B type neurilemmoma. The patient did not develop any complications. Based on preoperative images and intraoperative findings, we supposed that the tumor was derived from the cervical sympathetic nerve.