Clinical report of a parapharyngeal oncocytic carcinoma with parotid multinodular oncocytic hyperplasia

Tumors of the parapharyngeal space (PPS) account for only 0.5-1.5% of all head and neck neoplasms, but they represent both a diagnostic and therapeutic challenge. A 52-year-old man presented with a history of a right parotid nodule and a right parapharyngeal mass. At the fine-needle aspiration cytology the parotid nodule was compatible with a pleomorphic adenoma while no further investigations were performed for the parapharyngeal mass. The magnetic resonance imaging (MRI) showed a right prestyloid parapharyngeal tumor, and multiple nodules in the superficial lobe of the right parotid gland. The patient underwent a right superficial parotidectomy and parapharyngeal mass excision through a transparotid-trancervical approach. The histopathologic diagnosis of the parotid nodules was compatible with multinodular oncocytic hyperplasia (MNOH), while the parapharyngeal tumor was consistent with the diagnosis of oncocytic carcinoma associated with MNOH. Oncocytic carcinoma is a rare malignancy arising in the parapharyngeal space (PPS). An appropriate preoperative workup is crucial for a proper differential diagnosis.