Primary Neuroblastoma Arising in Parapharyngeal Space : A Case Report

Abstract

Although neuroblastoma is a relatively common malignancy of childhood, it is rare in the head and neck area. While less than 5% of neuroblastoma arise from the cervical sympathetic chain, the head and neck is mostly manifested with a metastatic disease. We encountered a case of primary neuroblastoma arising in the parapharyngeal space in an infant. The patient, a 7-month-old male, presented with multiple neck masses without any other symptoms. Urine VMA and HVA, the magnetic resonance image, an abdominal and chest computed tomogram, and a Tc(99m) MIBI tumor scan were performed. The diagnosis of differentiating neuroblastoma was made by a fine needle aspiration cytology. Complete surgical excision was performed at the expense of sacrificing the sympathetic nerve trunk. No recurrence was noted during the 1-year follow-up period, although the right-sided Horner's syndrome persisted. An accurate preoperative cytologic diagnosis and proper surgical intervention can result in a good prognosis for a low stage cervical neruoblastoma; however, a long term follow-up is indicated.