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.