A Suprise Diagnosis of Parapharyngeal Cavernous Hemangioma in an Adult

Parapharyngeal space contains many vital structures thus various pathology may arise from this region. Hemangiomas are benign rare vascular tumors that are histologically categorised as capillary, cavernous and mixed capillary. We were reporting a rare case of a  cavernous hemangioma in the parapharyngeal space. There are various diagnostic approaches in diagnosis of cavernous hemangioma. Imaging such as magnetic resonance imaging (MRI) is better than computed tomography (CT) scan. However, in this case we proceeded with contrasted CT scan where it showed well defined enhancing mass at the left parapharyngeal space with close proximity to the carotid artery. Asymptomatic cavernous hemangioma can be treated conservatively. Depending on the sites of the tumor, other treatment modalities that can be used such as systemic steroids, radiation, pre operative embolisation or scelerosing agents. Complete excision is the best in treating cavernous hemangiomas to prevent the recurrent of the disease. Hemangiomas should be considered as one of the differentials if a mass of soft tissue lesion with high vascularity  been revealed by imaging. In this case, there was a diagnostic dilemma. Parapharyneal hemangioma should be one of the differential diagnosis for any neck swelling over the parapharyngeal space. Complete excision of the tumor brings about the best favourable outcome, with a lower recurrence rate even without preoperative embolisation.