Lymphoma presenting as a parapharyngeal space tumour

Among all head and neck tumours, approximately 0.5% to 0.8% localize in the parapharyngeal space, with Non-Hodgkin’s lymphomas in this region being exceptionally rare. They are documented in the literature either as isolated cases or in small case series. Here, we present a case involving a middle aged man who exhibited 4 month history of dysphagia and hoarse voice. Upon examination, showed a bulged left side of the soft palate and medialization of the pharyngeal wall. CT and MRI revealed a large lesion in the left parapharyngeal region pushing the pharynx anteromedially. Similar intensity enhancing lesion noted in nasopharynx. A transoral excision of parapharyngeal mass was performed, revealing a large B-cell non-Hodgkin’s lymphoma. Typically, parapharyngeal space tumours are benign, and surgery is the preferred treatment. Patient was transferred to tertiary care oncology hospital for further treatment. This case underscores the rarity but potential presence of extranodal non-Hodgkin’s lymphomas in the head and neck. Recognizing this pathology is crucial due to the different treatment approach it necessitates.