Combined Endonasal-Transcervical Approach to a Metastatic Parapharyngeal Space Papillary Thyroid Carcinoma

Authors

Arnau Benet, Department of Otolaryngology-Head and Neck surgery. Department of Neurosurgery, University of California San Francisco.
Julio Plata Bello, Neurosurgery, Hospital Universitario de Canarias.
Ivan El-Sayed, Otolaryngology Head and Neck Surgery, University of California San Francisco.

Document Type

Article

Abstract

PURPOSE: Although papillary thyroid carcinoma metastases to the parapharyngeal space are rare, the high amount of fat tissue allows tumors to grow clinically undetectable until they invade most of the parapharyngeal space. We describe for the first time a combined endonasal and transcervical approach for a parapharyngeal metastasis from a papillary thyroid carcinoma. MATERIALS AND METHODS: A 51-year-old male with a previous history of papillary thyroid carcinoma presented with left ear fullness and left-sided facial numbness. Imaging revealed a 4x3 cm pre-styloid parapharyngeal space mass invading the foramen ovale and extending below the palate. Needle biopsy confirmed metastatic papillary thyroid carcinoma. RESULTS: The lesion was resected with a combined endoscopic endonasal and transcervical approach. Postoperative MRI revealed gross total resection, and the patient recovered from his symptoms. CONCLUSION: This novel approach provides access to pre-styloid parapharyngeal tumors with superior extension to the skull base, avoiding more extensive traditional open approaches.

Publication Date

7-1-2015

Publication Title

Cureus

ISSN

2168-8184

Volume

7

Issue

7

First Page

e285

PubMed ID

26203403

Digital Object Identifier (DOI)

10.7759/cureus.285

Recommended Citation

Benet, Arnau; Plata Bello, Julio; and El-Sayed, Ivan, "Combined Endonasal-Transcervical Approach to a Metastatic Parapharyngeal Space Papillary Thyroid Carcinoma" (2015). Neurosurgery. 2120.
https://scholar.barrowneuro.org/neurosurgery/2120