Fig 1. (a) Swelling of size 9x9cm in left parotid region which was non-tender, soft in consistency, smooth surface, (b) Smooth bulge seen over soft palate left side
Patient had reported with CECT scan of neck which showed heterogeneously enhancing lesion 35x44x47mm in size epicentered in left parapharyngeal space, pushing the parotid laterally with large number of arteries/ veins seen in and around the lesion. Lesion was in contact with left styloid and carotid space, superiorly abutting base of skull and medially pterygoid plates and sphenoid.
MRI neck showed hyperintense lesion in T1 and T2 of size 48x68x45mm with heterogenous post contrast enhancement. It was anteriorly closely abutting masseter with loss of fat planes, anteromedially involving prestyloid parapharyngeal space and masticator space displacing temporalis, medially eroding pterygoid plates displacing lateral and medial pterygoid muscle and narrowing oropharyngeal airway. It was closely abutting carotid vessels which were narrowed. Superiorly it was reaching base of skull without intracranial extension. Mandibular ramus was thinned out. (Fig 2a, 2b)