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Skull Base. 2002 November; 12(4): 215–220.
PMCID: PMC1656904

Giant Parapharyngeal Space Lipoma

Case Report and Surgical Approach


Large parapharyngeal space tumors near critical neurovascular structures pose challenging management problems. Only eight cases of a lipoma in the parapharyngeal space have been reported. We present a surgical approach that permits safe resection of such unusual tumors.

A 49-year-old man had a 2-year history of progressive pain in the left neck radiating from the shoulder to the occiput. Contrast-enhanced computed tomography (CT) of the neck demonstrated a fat-attenuation mass located in the poststyloid parapharyngeal space. The mass extended into the foramen transversarium at the level of the second cervical vertebra and encased the vertebral artery. The tumor was removed through an extended transcervical approach that included transection of the attachments of the sternocleidomastoid, trapezius, splenius capitus, and the longissimus capitus muscles. The approach provided access to the first cervical vertebra, allowing dissection of the tumor from the vertebral artery in the foramen transversarium. An extended transcervical approach provides exposure from the carotid artery to the vertebral artery and facilitates the complete excision of large parapharyngeal space masses.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Carrau RL, Myers EN, Johnson JT. Management of tumors arising in the parapharyngeal space. Laryngoscope. 1990 Jun;100(6):583–589. [PubMed]
  • Carrau RL, Johnson JT, Myers EN. Management of tumors of the parapharyngeal space. Oncology (Williston Park) 1997 May;11(5):633–642. [PubMed]
  • Elango S. Parapharyngeal space lipoma. Ear Nose Throat J. 1995 Jan;74(1):52–53. [PubMed]
  • Abdullah BJ, Liam CK, Kaur H, Mathew KM. Parapharyngeal space lipoma causing sleep apnoea. Br J Radiol. 1997 Oct;70(838):1063–1065. [PubMed]
  • Som PM, Biller HF, Lawson W, Sacher M, Lanzieri CF. Parapharyngeal space masses: an updated protocol based upon 104 cases. Radiology. 1984 Oct;153(1):149–156. [PubMed]
  • Hughes KV, 3rd, Olsen KD, McCaffrey TV. Parapharyngeal space neoplasms. Head Neck. 1995 Mar-Apr;17(2):124–130. [PubMed]
  • Pensak ML, Gluckman JL, Shumrick KA. Parapharyngeal space tumors: an algorithm for evaluation and management. Laryngoscope. 1994 Sep;104(9):1170–1173. [PubMed]
  • Higashi K, Sarashina N, Okamoto T, Matsuki C, Heim S. Supernumerary ring marker chromosome as a secondary rearrangement in a parapharyngeal lipoma with t(10;12)(q25;q15) as the primary karyotypic abnormality. Cancer Genet Cytogenet. 1992 Dec;64(2):163–165. [PubMed]
  • Goodwin WJ, Jr, Chandler JR. Transoral excision of lateral parapharyngeal space tumors presenting intraorally. Laryngoscope. 1988 Mar;98(3):266–269. [PubMed]
  • Krespi YP, Sisson GA. Transmandibular exposure of the skull base. Am J Surg. 1984 Oct;148(4):534–538. [PubMed]
  • Clayman GL, Adams GL. Modifications of the mandibular swing for preservation of occlusion and function. Head Neck. 1991 Mar-Apr;13(2):102–106. [PubMed]
  • Sasaki CT, Sims S, Drago P, McNelis E. Surgical anatomy of the vertebral artery at the skull base. Laryngoscope. 1992 Jul;102(7):829–831. [PubMed]

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