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False Identity: Lymphoid Hyperplasia Imitating a Large Paraganglioma

  • Karuna Dewan
  • Courtney B. Shires
Clinical Report
  • 4 Downloads

Abstract

The danger of the parapharyngeal space mass comes from the small space and vital neighboring structures. Its differential diagnosis is broad, however benign lymphoid hyperplasia in this region has not been previously reported. The clinical presentation, imaging, surgical findings and pathology slides were reviewed in an adult patient with a parapharyngeal space mass. The literature on somatostatin-positive parapharyngeal space lesions was reviewed. A 51-year old male with otalgia for 3 months, hearing loss, and tinnitus underwent audiogram, revealing asymmetric hearing loss. Laryngoscopy demonstrated a paretic true vocal cord. Subsequent MRI demonstrated 4.5 cm post-styloid parapharyngeal space mass displacing the carotid artery anterolaterally. Octreoscan scan showed significant uptake of the somatostatin analog. Angiogram showed prominent vascular blush. The mass was excised transcervically and histopathology demonstrated lymphoid hyperplasia. This case demonstrates that post-styloid parapharyngeal masses may be lateral retropharyngeal nodes. An octreotide-positive lymphoid hyperplasia has never been previously reported.

Keywords

Paraganglioma Parapharyngeal space Octreoscan 

Notes

Compliance with Ethical Standards

Conflict of interest

Courtney Shires and Karuna Dewan declared that they have no conflict of interest.

Human and Animal Rights

All procedures performed were in accordance with the ethical standards of the institutional IRB and with the 1964 Helskinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from the study patient. All treatments described here are within clinical standards of practice.

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Copyright information

© Association of Otolaryngologists of India 2018

Authors and Affiliations

  1. 1.Department of Otolaryngology Head and Neck SurgeryStanford UniversityStanfordUSA
  2. 2.Department of Otolaryngology Head and Neck SurgeryThe University of Tennessee Health Sciences CenterMemphisUSA

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