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Case No. 139
0000-00-00~0000-00-00
출제자 : 관리자
Hit : 301
| Period | 0000-00-00~0000-00-00 |
|---|---|
| Diagnosis | |
| Clinical information | 58세 남자, 6년 동안 존재한 neck mass로 내원 |
| Discussion | Schwannoma 영상소견 1. Cystic mass with internal hemorrhage, right parapharyngeal space poststyloid compartment - ICA가 앞으로 밀림 2. Tongue atrophy – secondary finding 가능성 높음. 3. tumor location과 tumor contour, 내부 hemorrhage 소견 등으로 진단 가능한 예임 Review of parapharyngeal space tumor 1. Anatomy of parapharyngeal space 1) Divided into two compartments by styloid process(more precisely. tensor-vascular-styloid fascia) 2) Laterally masticator and parotid space, medially pharyngeal mucosal space, posteromedially retropharyngeal space is located 2. Contents 1) Prestyloid compartment: minor or ectopic salivary gland, branches of the mandibular division of the trigeminal nerve, internal maxillary artery, ascending pharyngeal artery, and pharyngeal venous plexus 2) Poststyloid compartment : internal carotid artery, internal jugular vein, cranial nerves IX-XII, cervical sympathetic chain, and glomus bodies. 3. Neoplasm 1) Minor or ectopic salivary gland tumor A. Prestylolid location B. Preservation of the fat plane between the mass and the parotid gland extraparotid origin 2) Neurogenic tumor A. Most common poststyloid parapharyngeal space tumors, second most common prestyloid parapharyngeal space tumors B. Vagus nerve and sympathetic chain are posterior to the internal carotid artery Frequently, anteromedial displacement of the carotid sheath structures 3) Tumors from the other surrounding spaces A. Skull bass or vertebrae : chordomas, meningiomas B. Pharyngeal mucosal space lesion : nasopharynx carcinoma C. Deep lobe of the parotid gland : parotid tumors, most common extrinsic tumors involving the prestyloid parapharyngeal space D. Schwannomas and paragangliomas : may arise in the poststyloid parapharyngeal space and extend into the prestyloid parapharyngeal space E. Soft tissue sarcomas of fatty, muscular, or fibrous origin : infiltrative masses, usually associated bone destruction F. Castlemasn’s disease : prestyloid parapharygeal space |
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