Introduction:
Parapharyngeal space tumors account for only 0.5% of head and neck
tumors (1). However, they are deserve to receive desire attention since
with the tumor growth, important anatomical structures such as the
carotid artery, jugular vein, sympathetic chain, and cranial nerves can
be influenced (2).
Patients with parapharyngeal space tumors (PPS) usually represent a neck
or oropharyngeal mass without presence of detectable symptoms on
physical examination. The reason for the absence of symptoms is because
that only the inferior and medial boundaries of the PPS are distensible.
PPS lesions enlargement can lead to cranial neuropathies. With
compression of central nervous system (CNS) IX, X, XI, or XII, symptoms
of hoarseness, dysarthria, and dysphagia appear(3, 4).
Garcin syndrome is characterized by a progressive ipsilateral
involvement of cranial nerves, culminating in paralysis of at least
seven of them, with no sensory or motor long-tract disturbance, no
intracranial hypertension and with osteoclastic involvement in the skull
base on radiographic computed tomography(5). The underlying cause is
usually a sarcoma or carcinoma of the skull base(6, 7). Horner syndrome
results from an interruption of the sympathetic nerve supply to the eye
and is characterized by the classic triad of miosis (i.e. constricted
pupil), partial ptosis, and loss of hemifacial sweating (i.e.,
anhidrosis)(8). In benign lesions, pain is unusual but in cases with
compression or hemorrhage into the lesion, it ‘can be observed. Totally,
pain and neurologic dysfunction are more often indicative of malignancy
with infiltration of the skull base(9).
In this study, we report a parapharyngeal diffuse large Bcell lymphoma
in a human immunodeficiency virus (HIV) infected patient which had
caused the patient to suffer from Garcin syndrome.