Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Otorhinolaryngol. May 9, 2023; 10(2): 23-29
Published online May 9, 2023. doi: 10.5319/wjo.v10.i2.23
Transoral robotic surgery for adult parapharyngeal lymphangioma: A case report
Surender Dabas, Nandini N Menon, Reetesh Ranjan, Bikas Gurung, Himanshu Shukla, Ashwani K Sharma, Sukirti Tiwari, Ajit Sinha, Sahibinder Singh Bhatti, Rishu Sangal
Surender Dabas, Nandini N Menon, Reetesh Ranjan, Bikas Gurung, Himanshu Shukla, Ashwani K Sharma, Sukirti Tiwari, Ajit Sinha, Department of Surgical Oncology, BLK MAX Superspeciality Hospital, Delhi 110007, India
Sahibinder Singh Bhatti, Department of Pathology, BLK MAX Superspeciality Hospital, Delhi 110007, India
Rishu Sangal, Department of Radiology, BLK MAX Superspeciality Hospital, Delhi 110007, India
Author contributions: Dabas S, Menon NN, Shukla H, Ranjan R contributed to study concepts; Menon NN, Bhatti SS, Sangal R contributed to study design; Menon NN, Bhatti SS contributed to data acquisition; Menon NN, Shukla H, Ranjan R contributed to quality control of data; Dabas S, Menon NN, Ranjan R, Gurung B, Shukla H, Sharma AK, Tiwari S, Sinha A, Bhatti SS, Sangal R contributed to manuscript preparation, manuscript editing, manuscript reviewing.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Nandini N Menon, MBBS, MS, Attending Doctor, Department of Surgical oncology, BLK MAX Superspeciality Hospital, Karol Bagh, Delhi 110007, India. menonnandini1602@gmail.com
Received: October 13, 2022
Peer-review started: October 13, 2022
First decision: December 13, 2022
Revised: December 17, 2022
Accepted: February 9, 2023
Article in press: February 9, 2023
Published online: May 9, 2023
Abstract
BACKGROUND

Lymphangiomas are a group of benign swellings which are commonly seen in children. The most common sites of presentation is the head and neck region, less commonly seen in axilla, chest, liver, spleen, etc. The ideal modality of treatment has always been surgical excision irrespective of the site and age group. But with the advent of minimally invasive surgical techniques, it is now possible to perform excision of parapharyngeal space lesions with minimal morbidity and good clearance.

CASE SUMMARY

A 42-year-old male patient who presented with difficulty in swallowing and had undergone surgery twice outside, where Transcervical approach was attempted to remove the parapharyngeal mass, but failed. Magnetic resonance imaging scan demonstrated a 6 cm x 5 cm x 4 cm left parapharyngeal mass. He underwent transoral robotic surgery for the excision of the parapharyngeal lesion and had an uneventful post-operative recovery.

CONCLUSION

Lymphangiomas are hamartomatous swellings which are benign in nature. The symptoms of the patient with large parapharyngeal mass include dysphagia, dyspnoea and neck swelling. Clinicoradiological evaluation is of utmost importance to determine the adjacent vital structures and the approach to the tumor. With the advent of robotics in oncology, transoral robotic excision is one of the best approaches to perform such a surgery.

Keywords: Lymphangioma, Parapharyngeal space lesions, Transoral robotic surgery for parapharyngeal space mass, Case report

Core Tip: This report describes a rare case of adult parapharyngeal space lymphangioma. It also emphasizes the role of minimally invasive techniques like transoral robotic surgery for the excision of parapharyngeal space tumors which has resulted in less morbidity in the patients and gives good clearance of tumor.