Abstract
Parapharyngeal space (PPS) tumors are extremely rare in the pediatric population, accounting for a small fraction of all head and neck neoplasms. The majority of neoplasms in the PPS are benign tumors. We present a case of an eight-year-old male with a large PPS ganglioneuroma, who presented with a neck mass that had been progressing over five years with no symptoms of dysphasia. Diagnostic imaging, including computed tomography scan and magnetic resonance imaging with contrast, revealed a large, heterogeneously enhancing mass, measuring about 4.47 × 6.49 × 2.56 cm in size, in the right poststyloid PPS. The tumor extended closely from the common carotid artery bifurcation to the skull base, without intracranial extension. A transcervical surgical approach enabled complete tumor excision without complications. Postoperative histopathology confirmed the diagnosis of ganglioneuroma, a very rare case in pediatric PPS tumors. No postoperative complications were noted, and follow-up over two years revealed no signs of recurrence.