Parapharyngeal masses are uncommon and often stem from infectious processes originating in the oral cavity or pharynx, leading to abscess formation. In rarer cases, these lesions can be neoplastic, as tumors in the parapharyngeal space represent less than 1% of all head and neck neoplasms. This report discusses the case of a patient presenting with mandibular pain, which prompted further investigation. Comprehensive multiparametric diagnostic imaging revealed the presence of a parapharyngeal mass. To obtain a definitive diagnosis, an ultrasound-guided biopsy was performed using a transcutaneous approach, specifically employing a high median technique at the neck level to target the mass situated in the right tonsillar region.
Histological examination of the biopsy samples ultimately led to the diagnosis of sarcomatoid carcinoma. This case underscores the importance of utilizing ultrasound-guided techniques for the accurate characterization of parapharyngeal masses, as they can provide valuable insights into the nature of these lesions. The rarity of parapharyngeal tumors necessitates a high index of suspicion when evaluating neck masses, especially in patients presenting with symptoms such as mandibular pain. The application of advanced imaging modalities and minimally invasive biopsy techniques can significantly enhance diagnostic accuracy, thereby facilitating timely and appropriate treatment interventions for patients with potentially malignant conditions in this challenging anatomical region.
