Fig 1. (a) Swelling of size 9x9cm in left parotid region which
was non-tender, soft in consistency, smooth surface, (b) Smooth bulge
seen over soft palate left side
Patient had reported with CECT scan of neck which showed heterogeneously
enhancing lesion 35x44x47mm in size epicentered in left parapharyngeal
space, pushing the parotid laterally with large number of arteries/
veins seen in and around the lesion. Lesion was in contact with left
styloid and carotid space, superiorly abutting base of skull and
medially pterygoid plates and sphenoid.
MRI neck showed hyperintense lesion in T1 and T2 of size 48x68x45mm with
heterogenous post contrast enhancement. It was anteriorly closely
abutting masseter with loss of fat planes, anteromedially involving
prestyloid parapharyngeal space and masticator space displacing
temporalis, medially eroding pterygoid plates displacing lateral and
medial pterygoid muscle and narrowing oropharyngeal airway. It was
closely abutting carotid vessels which were narrowed. Superiorly it was
reaching base of skull without intracranial extension. Mandibular ramus
was thinned out. (Fig 2a, 2b)