Extensive parapharyngeal and skull base XXXX ; a challenge for differential diagnosis and treatment: case report.

@entity1 @entity649 @entity5274 @entity3611 @entity1224
CONTEXT: @entity3611 has been defined as a mass composed of differentiated neuroectodermal tissue isolated from the spinal canal or cranial cavity and remains rare. This lesion has to be considered in the differential diagnosis among newborn @entity1 with classical symptoms of @entity649 , neck mass and feeding difficulties. We present a rare case of extensive parapharyngeal and skull base @entity3611 in 6-month-old @entity1 who presented respiratory and feeding obstruction at birth. CASE REPORT: a six-month-old @entity1 who presented upper respiratory and feeding obstruction at birth and was using tracheostomy and @entity5274 was referred to our institution. Complete surgical excision of the mass consisted of a transcervical-transparotid approach with extension to the infratemporal fossa by means of a lateral transzygomatic incision, allowing preservation of all vital neurovascular structures. The anatomopathological examination showed a solid mass with nests of neural tissue, with some neurons embedded in poorly encapsulated fibrovascular stroma, without mitotic areas, and with presence of functioning choroid plexus in the immunohistochemistry assay. Neurovascular function was preserved, thus allowing postoperative decannulation and oral feeding. Despite the large size of the mass, the @entity1 has completed one year and six months of follow-up without complications or recurrence. @entity3611 needs to be considered in diagnosing @entity1224 . Surgical treatment is the best choice and should be performed on clinically stable @entity1 . An algorithm to guide the differential diagnosis and improve the treatment was proposed.
