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case_images: Pre-treatment MR showed a right parapharyngeal space tumor.
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case_images: An MRI of the pharyngeal showed a 4.5 cm x 3.0 cm x 2.0 cm soft tissue lesion in the right parapharyngeal space adjoining the carotid sheath (Figure 1).
case_images: The histopathological examination: The tumor cells grow infiltratingly and are irregularly nested or scattered. Most of the tumor cells are spindle-shaped. (HE stained).
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case_images: The pathology was initially read as positive for undifferentiated carcinoma (Figure 2).
case_images: MR after neoadjuvant chemotherapy showed a partial response of the right parapharyngeal space tumor.
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case_images: Restaging MRI scan of the head and neck showed a decreasing size of the right parapharyngeal space tumor (Figure 3).
case_images: Axial CT, sagittal CT and coronal CT showing isodose lines for the right parapharyngeal space radiation treatment fields.
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case_images: December 2017, she received intensity-modulated radiotherapy to the residual tumor and the lymph node area to a total dose of 74 Gy in 37 fractions and 50 Gy in 25 fractions respectively (Figure 4). During the 8-week radiation therapy, she received concurrent chemotherapy of Ifosfamide 1500 mg/m2 given every three weeks.
case_images: Post-treatment MR showed a completed response of the right parapharyngeal space tumor.
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case_images: A follow up restaging MRI scan of the head and neck showed a complete response of the right parapharyngeal space tumor (Figure 5).