95 Kulak Burun Bogaz Ihtis Derg 2009;19(2):95-98 Case Report / Olgu Sunumu B E H B U T C E V A N ŞİR KU LA K BU RU N B O Ğ A Z H A S T A L I K LA R I V E B A Ş B O Y UN C ER R A HİSİ D E R N E Ğ İ . . Parapharyngeal lipoma: a case report Parafarengeal lipoma: Olgu sunumu Alper Tunga Derin, M.D., Kenan Güney, M.D., Murat Turhan, M.D., Bülent V. Ağırdır, M.D. A 44-years-old male presented with right infraau- ricular swelling. It had been four months since he was aware of the mass. He had not felt any pain or tenderness. Computed tomograpy demonstrated a homogenous, regular surfaced mass located in the prestyloid and poststyloid parapharyngeal space. Its density was concordant with lipomatous tissue, so it was considered to be an infiltrating parapharyngeal lipoma. Postoperative diagnosis revealed a similar result. We believe that computed tomograpy is an effective method of diagnosing parapharyngeal space tumors and tansparotid approach for this localization is very useful for both preserving facial nerve functions and exposing the mass clearly. We report a case of parapharyn- geal lipoma slightly invading the deep lobe of the parotid gland. Key Words: Computed tomography; lipoma; neoplasm, parotid; parapharyngeal space; tumor. Kırk dört yaşında erkek hasta sağ tarafında kulak altında şişlik yakınması ile kliniğimize başvurdu. Öyküsünden hastanın dört aydır kitlenin farkında olduğu ve her - hangi bir ağrı ya da hassasiyet hissetmediği anlaşıldı. Bilgisayarlı tomografi incelemesinde prestiloid ve post - stiloid parafarengeal mesafeyi tutan, homojen, düzgün yüzeyli bir kitle saptandı. Kitlenin yoğunluğu yağ doku- suyla uyumluydu ve bu yüzden infiltran parafarengeal lipoma olarak değerlendirildi. Ameliyat sonrasındaki patolojik tanı da benzer sonucu gösterdi. İnanıyoruz ki bilgisayarlı tomografi prafarengeal bölge tümörlerinin tanısında oldukça etkili bir yöntemdir ve bu alandaki tümörlerin tedavisinde transparotid yaklaşım hem fasi- al sinir fonksiyonlarının korunmasında hem de kitlenin ekspoze edilmesinde değerli bir yöntemdir. Bu makale- de parotid glandın derin lobunu hafifçe invaze eden bir parafarengeal lipoma olgusu sunuldu. Anahtar Sözcükler: Bilgisayarlı tomografi; lipoma; neop- lazma, parotid; parafarengeal alan; tümör. Lipomas are the most common benign mesenchimal tumors with a prevalence rate of 2.1 per 100 people. [1] Most of them are small, weighing only a few grams and usually less than 2 cm in dimension. However, presentation of a lipoma in the head and neck is extremely rare, especially in infiltrating forms. Rarer still are infiltrating lipomas reported to be localized in the parapharyngeal region. [2] Here we present an additional case of parapharyngeal lipoma which minimally invaded the deep lobe of the parotid gland. We discussed our diagnostic work-up and treatment strategies in the light of the literature. CASE REPORT A 44-old-male was referred to our clinic with a right infra-auricular swelling. It had been four months since he had recognized the mass. He had not felt any pain or tenderness. On physical examination, a 5x5 cm mass located in the right parotid location was felt, which was soft on palpation and did not Department of Otolaryngology, Medicine Faculty of Akdeniz University, Antalya, Turkey Received / Geliş tarihi: May 16, 2007 Accepted / Kabul tarihi: September 5, 2007 Correspondence / İletişim adresi: Alper Tunga Derin, M.D. Akdeniz Üniversitesi Tıp Fakültesi Kulak Burun Boğaz Hastalıkları Anabilim Dalı, 07059 Antalya, Turkey. Tel: +90 242 - 249 68 50 Fax (Faks): +90 242 - 227 44 90 e-mail (e-posta): atderin@akdeniz.edu.tr