Presacral tumors are rare. Neurogenic tumors in this area are even rarer with only case reports and short case series being reported in the literature. Most of these tumors remain asymptomatic till they reach a size large enough to cause pressure symptoms. Magnetic resonance imaging (MRI) of the pelvis is the most preferred imaging modality for preoperative diagnosis as well treatment planning. Complete surgical resection is the treatment of choice. The approach to surgical resection depends on the type of tumor.
Parapharyngeal space (PPS) tumors offer significant surgical challenges owing to their rarity, difficult anatomy, and presence of vascular structures nearby. Although most of the tumors in the prestyloid compartment of PPS are benign, malignant neoplasms have been reported infrequently. Pleomorphic adenoma, although the most common benign salivary gland tumor, is rarely found to arise from the minor salivary glands of PPS.