title: Wegener's Granulomatosis Presenting as a Parapharyngeal Mass.
abstract: BACKGROUND
  Wegener's Granulomatosis (WG) is classically characterized by the triad of sinonasal, pulmonary, and renal manifestations. However, a growing body of research has demonstrated that atypical head and neck pathologies including retropharyngeal and parapharyngeal lesions are often the presenting feature of patients found to have WG.
  
  
  METHODS
  This report describes the hospital course of a patient who presented with a parapharyngeal mass with secondary superior cervical chain compression and Lemierre's Syndrome. We discuss how a stepwise approach involving a multidisciplinary team led to the diagnosis of WG.
  
  
  CONCLUSIONS
  To our knowledge, this report is the first description of a patient presenting with a parapharyngeal mass causing superior cervical chain compression with simultaneous Lemierre's Syndrome who was ultimately diagnosed with WG. We highlight how the early consideration of WG in patients with atypical head and neck lesions refractory to multiple treatment regimens can led to an expeditious diagnosis and the coordination of appropriate short-term and long-term care.
authors.affiliation: Tulane University School of Medicine in New Orleans, LA.
authors.forename: Ryan E
authors.initials: RE
authors.lastname: Nelson
authors.affiliation: Tulane University School of Medicine in New Orleans, LA.
authors.forename: Douglas M
authors.initials: DM
authors.lastname: Hildrew
authors.affiliation: Louisiana State University School of Medicine in New Orleans, LA.
authors.forename: Tyler
authors.initials: T
authors.lastname: Deblieux
authors.affiliation: Tulane University School of Medicine in New Orleans, LA.
authors.forename: Jesse A
authors.initials: JA
authors.lastname: Guittard
authors.affiliation: Louisiana State University School of Medicine in New Orleans, LA.
authors.forename: Todd M
authors.initials: TM
authors.lastname: Brickman
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging; D003251:Constriction, Pathologic / Q000209:etiology; D003937:Diagnosis, Differential; D014890:Granulomatosis with Polyangiitis / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D057831:Lemierre Syndrome / Q000150:complications* / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008297:Male; D010608:Pharyngeal Diseases / Q000175:diagnosis / Q000209:etiology*; D014057:Tomography, X-Ray Computed; D055815:Young Adult