title: Diagnostic dilemma involving a mass in the parapharyngeal space: A metastatic breast carcinoma masquerading as a malignant salivary gland tumor.
abstract: Parapharyngeal space (PPS) tumors are rare and account for about 0.5% of all head and neck neoplasms. Most PPS tumors are benign (up to 80%) while the remaining 20% are malignant. These tumors are either primaries; most commonly arising from salivary glands or metastatic tumors or due to direct extension of tumors from the adjacent sites. Distant metastasis from breast cancers more commonly involves the lungs, bones, brain and liver. Metastasis to the PPS from a primary breast carcinoma is rare, with only one case reported in literature. We, to the best of our knowledge report the second case of a carcinoma breast metastasizing to the PPS and further discuss the diagnostic and therapeutic challenges involved in its management. A fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography scan apart from explicitly defining the extent of the PPS tumor, majorly influenced the therapeutic decision making process by ruling out other sites of metastasis.
authors.affiliation: Department of Pathology, Cancer Institute (WIA), Chennai, Tamil Nadu, India.
authors.forename: Kanchan
authors.initials: K
authors.lastname: Murhekar
authors.affiliation: Department of Pathology, Cancer Institute (WIA), Chennai, Tamil Nadu, India.
authors.forename: Urmila
authors.initials: U
authors.lastname: Majhi
authors.affiliation: Department of Surgical Oncology, Cancer Institute (WIA), Chennai, Tamil Nadu, India.
authors.forename: Arvind
authors.initials: A
authors.lastname: Krishnamurthy
authors.affiliation: Department of Preventive Oncology, Cancer Institute (WIA), Chennai, Tamil Nadu, India.
authors.forename: Vijayalakshmi
authors.initials: V
authors.lastname: Ramshankar
keywords: Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography; malignant salivary gland tumors; metastatic breast carcinoma; parapharyngeal space tumors