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Shah R, Venkatesh R, Badi K, Shah K. Surgical management of intramuscular hemangioma of left masseter muscle: A case report. Natl J Maxillofac Surg 2024; 15:160-163. [PMID: 38690251 PMCID: PMC11057590 DOI: 10.4103/njms.njms_140_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/05/2022] [Accepted: 12/09/2022] [Indexed: 05/02/2024] Open
Abstract
Hemangiomas are benign soft tissue tumors which are congenital and occur due to abnormal proliferations of blood vessels. Most common location of hemangiomas is subcutaneous adipose tissue, but skeletal muscle hemangiomas are very rare which make up to 0.8% of all hemangiomas. Usually, the intramuscular lesions are common in thigh region and calf muscles and are relatively rare in the facial muscles. Long-standing lesions results in phleboliths, and this may cause some symptoms. Conventional treatment of these isolated lesions may not yield satisfactory results. Hence, surgical excision of the lesion in toto results in aesthetically pleasing results with low chances of recurrence. In this article, we report a case of a left masseter intramuscular hemangioma in 19-year-old patient which was successfully managed by complete surgical excision.
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Affiliation(s)
- Rishabh Shah
- Department of Oral and Maxillofacial Surgery, K M Shah Dental College and Hospital, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat, India
| | - Rashmi Venkatesh
- Department of Oral Medicine and Radiology, K M Shah Dental College and Hospital, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat, India
| | - Kavita Badi
- Department of Oral Medicine and Radiology, K M Shah Dental College and Hospital, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat, India
| | - Kreena Shah
- Department of Oral and Maxillofacial Surgery, K M Shah Dental College and Hospital, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat, India
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Sellami M, Ayadi S, Sellami N, Triki M, Souissi B, Boudaouara T, Ben Mahfoudh K, Charfeddine I. An intramuscular hemangioma of the semispinalis muscle: A case report. SAGE Open Med Case Rep 2023; 11:2050313X231205800. [PMID: 37860284 PMCID: PMC10583517 DOI: 10.1177/2050313x231205800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 09/18/2023] [Indexed: 10/21/2023] Open
Abstract
Intramuscular hemangiomas are uncommon benign endotheliomas that typically occur in the trunk and limbs. Head and neck involvement is relatively infrequent, with the masseter muscle being the most commonly affected site. We present a rare case of intramuscular hemangiomas arising from the semispinalis muscle. A 31-year-old male presented with a painless swelling in the left upper neck region, gradually increasing in size over the past year. Imaging studies revealed a well-defined mass originating from the semispinalis muscle. Surgical excision was performed successfully, and histological examination confirmed the diagnosis of a mixed intramuscular hemangioma. The patient remained recurrence-free during the 2-year follow-up period. Intramuscular hemangiomas in the posterior neck muscles are rare, with only a few reported cases. Wide surgical resection with control of feeding vessels is the optimal treatment, and follow-up is recommended to monitor for local recurrence. This case report highlights the clinical presentation, diagnostic challenges, and successful surgical management of intramuscular hemangiomas in a unique location, emphasizing the importance of accurate diagnosis and appropriate treatment of this rare tumor.
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Affiliation(s)
- Moncef Sellami
- Department of Otorhinolaryngology-Head and Neck Surgery, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Sirine Ayadi
- Department of Otorhinolaryngology-Head and Neck Surgery, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Nesrine Sellami
- Department of Otorhinolaryngology-Head and Neck Surgery, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Meriem Triki
- Department of Pathology and Research Laboratory, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Basma Souissi
- Department of Radiology, Habib Bourguiba Hospital, Sfax, Tunisia
| | - Tahia Boudaouara
- Department of Pathology and Research Laboratory, Habib Bourguiba University Hospital, Sfax, Tunisia
| | | | - Ilhem Charfeddine
- Department of Otorhinolaryngology-Head and Neck Surgery, Habib Bourguiba University Hospital, Sfax, Tunisia
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AlAbdulhadi HA, AlFayyadh MA, AlBadri KS. Intramuscular hemangioma of the pretarsal orbicularis oculi muscle in an adult treated with intralesional bleomycin injections. Am J Ophthalmol Case Rep 2022; 26:101456. [PMID: 35252628 PMCID: PMC8891707 DOI: 10.1016/j.ajoc.2022.101456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 01/21/2022] [Accepted: 02/20/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose Intramuscular hemangiomas of the head and neck are rare and account for fewer than 1% of total cases. Reports of intramuscular hemangiomas in adults' eyelids, orbital and periorbital regions are especially scarce, conceivably because occurrence in the masseter muscle is more common. Herein we report a highly unusual case of hemangioma located in the pretarsal orbicularis oculi muscle of an adult patient. This report describes the clinical and pathological assessment of the patient, subsequent diagnosis of periorbital intramuscular hemangioma, and conception and implementation of a treatment approach using intralesional bleomycin injections. Observations A 29-year-old female patient without other clinical complaints presented with an enlarged, painless mass in the upper left eyelid. Physical examination of the mass suggested a vascular origin, and hemangioma diagnosis was confirmed by computed tomography and incisional biopsy. The anatomical location was determined as the pretarsal orbicularis oculi muscle involving mixed capillary-sized and cavernous-sized vessels. The treatment strategy involved monthly intralesional bleomycin injections (1 mL volume; 3 IU/mL) for 4 consecutive months resulting in notable size reversion. The patients experienced no associated complications, and the size remained stable over the 2-year follow-up period. Conclusions Intralesional bleomycin injections may offer an effective and safe treatment option for intramuscular hemangioma in the periorbital region. However, larger studies are needed to substantiate these findings further. Intramuscular hemangiomas in adults' heads and necks are rare. Periorbital intramuscular hemangioma was clinically and pathologically assessed. Patient treated with intralesional bleomycin injections for 4 consecutive months. The patient had no complications, and the size remained stable over 2 years.
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Alqahtani AA, AlQarni AA, Abbas MM, Alkhani AM. Temporal Muscle Cavernous Hemangioma: A Case Report and Literature Review. Cureus 2022; 14:e23166. [PMID: 35444904 PMCID: PMC9010010 DOI: 10.7759/cureus.23166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2022] [Indexed: 11/08/2022] Open
Abstract
Hemangiomas are nonmalignant vascular lesions commonly seen in both the skin and mucosa that rarely occur in skeletal muscles. According to the type of vessel, a hemangioma can be differentiated into capillary, cavernous, or mixed types. The following report describes a case of temporalis muscle hemangioma in a 45-year-old female who presented with painful swelling in the left outer orbital wall, which had been growing in size over the past 12 months. CT scan and MRI revealed a well-demarcated lesion in the temporalis muscle measuring 10 mm × 13 mm × 15 mm. Surgical resection of the lesion was performed, allowing a definitive diagnosis of cavernous hemangioma to be made histologically. As radiological images are mainly inadequate for definitively diagnosing these lesions, surgical intervention is usually required. The recurrence rate differs among the three subtypes; thus, clinical follow-up and radiological imaging as needed are recommended.
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Zhu D, Dai X, Wang J, Zhang C, Tao X, Wu L, Zhu L. Imaging Findings From Different Pathological Types of Oral and Maxillofacial Intramuscular Hemangiomas for Selecting Optimum Management. Front Oncol 2022; 11:792554. [PMID: 35174069 PMCID: PMC8841851 DOI: 10.3389/fonc.2021.792554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 12/27/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives To assess computed tomography (CT) and magnetic resonance imaging (MRI) findings of intramuscular hemangiomas (IMHs) in oral and maxillofacial region and correlate them with the histopathological classifications for selecting optimum management. Methods The clinical data and pretreatment findings of 32 patients with pathologically proven IMHs on CT (n = 10), MRI (n = 27), or both (n = 5) were analyzed retrospectively. Correspondence of clinical and imaging characters with 3 different pathological classifications (cavernous, capillary, and mixed) of IMHs was studied. A number of pitfalls and overlap of imaging features can result in misdiagnosis of different IMHs lesions. Results Four patients had multi-muscular lesions, and 28 had single-muscular lesions. The predilection site were the tongue (11 cases, 34.4%) and the masseter muscle (10 cases, 31.2%). Cavernous type (17 cases, 53.1%) was the most common IMHs type. All patients showed slightly hypointense or isointense on T1-weighted imaging, 3 patients showed hyperintense on T2-weighted imaging and the others showed slightly hyperintense. The most common enhancement pattern was progressive (29 cases, 90.6%). The capillary type (9 cases, 28.1%) and mixed type (6 cases, 28.1%) of IMHs on imaging indicated characteristics of lesions with rich blood supply status, the cavernous type (17cases, 53.1%) of IMHs belonged to relatively poor blood supply lesions. A total of 5 patients (15.6%) were initially misdiagnosed, there were recurrences in 4 IMHs patients. Extra functional MRI (fMRI) was performed on these 5 misdiagnosed patients, the average ADC of the 5 patients was 1.50 × 10−3 mm2/s. The presence of vermicular vessels was different among these three types of IMHs. Conclusions The reason for the misdiagnosis in localized IMHs may be the obvious border of mass-like lesions and the lack of enlarged vessels. Combined evaluation of presence of vermicular vessels and fMRI might be more accurately for determining the IMHs and create a preoperative plan.
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Affiliation(s)
- Dan Zhu
- Department of Radiology, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Xiaoqing Dai
- Department of Radiology, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Jingbo Wang
- Department of Radiology, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Chunye Zhang
- Department of Pathology, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Xiaofeng Tao
- Department of Radiology, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Lizhong Wu
- Department of Radiology, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
- *Correspondence: Lizhong Wu, ; Ling Zhu,
| | - Ling Zhu
- Department of Radiology, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
- *Correspondence: Lizhong Wu, ; Ling Zhu,
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Park D, Park S, Baik B, Kim S. A hemangioma in the masseter muscle: a case report. Arch Craniofac Surg 2021; 22:218-221. [PMID: 34474547 PMCID: PMC8413925 DOI: 10.7181/acfs.2021.00283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 08/20/2021] [Indexed: 11/24/2022] Open
Abstract
Intramuscular hemangiomas of the masseter muscle are uncommon tumors and therefore can be difficult to accurately diagnose preoperatively, due to the unfamiliar presentation and deep location in the lateral face. A case of intramuscular hemangioma of the masseter muscle in a 66-year-old woman is presented. Doppler ultrasonography showed a 34× 15 mm hypoechoic and hypervascular soft tissue mass in the left masseter muscle, suggesting hemangioma. The mass was excised via a lateral cervical incision near the posterior border of the mandibular ramus. The surgical wound healed well without complications.
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Affiliation(s)
- Daehwan Park
- Department of Plastic and Reconstructive Surgery, Dongkang Medical Center, Ulsan, Korea
| | - Sulki Park
- Department of Plastic and Reconstructive Surgery, Dongkang Medical Center, Ulsan, Korea
| | - Bongsoo Baik
- Department of Plastic and Reconstructive Surgery, Dongkang Medical Center, Ulsan, Korea
| | - Sunyoung Kim
- Department of Pathology, Dongkang Medical Center, Ulsan, Korea
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Bentham R, Jordan DR, Farmer J. A rare case of intramuscular angioma involving the medial rectus muscle. Orbit 2021; 41:647-652. [PMID: 33957847 DOI: 10.1080/01676830.2021.1918179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Benign benign vascular tumors (e.g., hemangiomas) and malformations are commonly encountered lesions in all ages of life, especially in infancy and childhood. Hemangiomas are considered to be proliferative vascular lesions while malformations are defects of embryonal vascular morphogenesis. Less than 1% of hemangiomas within the body occur in skeletal muscle and of these approximately 15% have been reported to occur in the head and neck musculature (e.g. masseter, trapezius, sternocleidomastoid, mylohyoid, temporalis muscles) Intramuscular angioma (the preferred term for lesions formerly known as intramuscular hemangiomas by WHO Tumors of Soft Tissue and Bone Classification, 5th edition 2020) (IA) occurring in the extraocular muscles or palpebral muscles (orbicularis oculi) are extremely rare with only a few case reports in the English literature. To date, all the extraocular muscles have reportedly been involved. With the case reported herein, the medial rectus muscle appears to be the most common extraocular muscle involved.
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Affiliation(s)
- Ricarda Bentham
- Department of Ophthalmology and Pathology, University of Ottawa and the Ottawa Hospital, Ottawa, Ontario, Canada
| | - David R Jordan
- Department of Ophthalmology and Pathology, University of Ottawa and the Ottawa Hospital, Ottawa, Ontario, Canada
| | - James Farmer
- Department of Ophthalmology and Pathology, University of Ottawa and the Ottawa Hospital, Ottawa, Ontario, Canada
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Yu D, Choi JH, Jeon I. Intramuscular hemangioma with hemorrhagic transformation arising from paraspinal muscles of posterior neck: A case report. Medicine (Baltimore) 2020; 99:e21741. [PMID: 32872061 PMCID: PMC7437785 DOI: 10.1097/md.0000000000021741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
RATIONALE Hemangiomas are usually found in cutaneous or mucosal layers, less than 1% of hemangiomas develop in skeletal muscles. Intramuscular hemangioma (IH) in the head and neck areas is relatively infrequent, accounting for 15% of IH. Most of them are identified as a benign mass, and rapid changes in size or internal bleeding are rare. PATIENT CONCERNS A 60-year-old female patient presented with a 2-week history of sudden onset posterior neck pain. There was no neurological deficit except limited neck motion due to pain. The palpable mass was noted on the paraspinal muscles of cervicothoracic junction, which was located midline to left side portion with tenderness. DIAGNOSES Magnetic resonance imaging demonstrated a round shaped, multi-lobulated, and well-defined mass lesion (4.1 × 2.6 × 0.9 cm) embedded from the inter-spinous space of T1-2 to the left paraspinal muscles. The lesion was iso-intense on T2-weighted images (WI), iso- to slightly low-intense on T1-WI, heterogeneous enhancement of intra- and peri-mass lesion on contrast-enhanced T1-WI. Vascular structures presented as signal voids were identified internally and around the mass lesion. Histological examination revealed a mixed-type hemangioma. INTERVENTIONS The mass was removed completely including some of the surrounding muscles where boundaries were unclear between the mass and surrounding muscles with ligation of peritumoral vessels. Dark-brown colored blood was drained from the ruptured tumor capsule during the dissection. There was no bony invasion. OUTCOMES The preoperative symptoms improved immediately after the operation. There is no residual or recurrence lesion by the 15-months follow-up. LESSONS IH with hemorrhagic transformation in the head and neck is extremely rare. In the case of intramuscular tumors accompanied by a sudden onset of severe acute pain, we recommend considering a differential diagnosis of IH with hemorrhagic transformation. Complete resection of the tumor mass including surrounding muscles is required to prevent recurrence.
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Affiliation(s)
| | - Joon Hyuk Choi
- Department of Pathology, Yeungnam University Hospital, Yeungnam University College of Medicine, Daegu, South Korea
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Endoscope-Assisted Resection of Intramuscular Cavernous Hemangioma Within the Temporal Muscle. J Craniofac Surg 2019; 30:193-195. [PMID: 30475294 DOI: 10.1097/scs.0000000000004933] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Hemangiomas are benign vascular soft tissue tumors, which most frequently occur in the skin or subcutaneous tissue. Intramuscular hemangiomas typically occur in the trunk and extremities and less frequently in the head and neck. Among these, those occurring in the temporalis muscle are extremely rare. The authors report the case of a 43-year-old Japanese male with a mass in his left temporal fossa. Computed tomography images showed no erosion of the zygomatic bone, and magnetic resonance imaging revealed an ovoid well-marginated mass within the temporal muscle. The lesion was surgically excised with an endoscopy procedure used for minimally invasive lesions and complete removal. Histopathological examination confirmed the diagnosis of intramuscular cavernous hemangioma. The postoperative clinical course was good, with no indications of temporary nerve paralysis. No signs of local recurrence were observed postoperatively. Therefore, a cavernous hemangioma should be suspected when a mass occurs in the temporal region with accompanying radiologic findings suggesting vascular origin. In surgical treatment, the endoscopy-assisted technique is very useful to achieve complete tumor resection and prevent relapse while avoiding serious complications due to surgical procedures.
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Cui B, Wang DH, Wang GJ, Cheng P, Zhang F, Duan XB, Zhao ZF. Cavernous hemangiomas of the temporalis muscle with prominent formation of phleboliths: Case report and review of the literature. Medicine (Baltimore) 2017; 96:e8948. [PMID: 29310392 PMCID: PMC5728793 DOI: 10.1097/md.0000000000008948] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 11/06/2017] [Accepted: 11/08/2017] [Indexed: 12/30/2022] Open
Abstract
RATIONALE Hemangiomas are benign tumors characterized by an abnormal proliferation of blood vessels, most often occur in the skin and subcutaneous tissue, intramuscular hemangioma, a distinctive type of hemangioma within the skeletal muscle, account for <1% of all hemangiomas, temporalis muscle is a very uncommon site, cavernous hemangioma of the temporalis muscle with prominent formation of phleboliths is rare reported. PATIENT CONCERNS A 62-year-old man presented with a slowly increased mass in his right temporal fossa. DIAGNOSES Computed tomography (CT) scan showed the lesion across the zygomatic arch, with many calcified nodules differ in sizes and no erosion to the bone, magnetic resonance imaging (MRI) showed an oval lesion with hypointense and isointense on T2-weighted imaging within the temporal muscle, and preoperation diagnosis was hemangioma. INTERVENTIONS The tumor was resected under general anesthesia. OUTCOMES The mass was excised completely, and the histopathology examination confirmed the diagnosis of cavernous hemangioma with prominent formation of phleboliths. The patient recovered very well without dysfunctions. LESSONS Cavernous hemangioma should be suspected when mass occurs in this region. CT and MRI are important for the early diagnosis of tumor, and resection the tumor completely is recommended.
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Affiliation(s)
| | - Dan-Hui Wang
- Department of neurology, Xuchang Central Hospital, Henan, China
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Park JW, Kim CH, Moon CW. Intramuscular hemangioma in buccal cheek: a case report. J Korean Assoc Oral Maxillofac Surg 2017; 43:262-266. [PMID: 28875141 PMCID: PMC5583201 DOI: 10.5125/jkaoms.2017.43.4.262] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 01/14/2017] [Accepted: 01/26/2017] [Indexed: 12/11/2022] Open
Abstract
Hemangioma is the most common benign tumor of a vascular origin, and is characterized by the abnormal proliferation of blood vessels. Intramuscular hemangioma (IMH) usually involves the skeletal muscles of the trunk or limbs, but rarely occurs in the head and neck region. This case report presents a patient with IMH showing multiple phleboliths in the buccal cheek. A 13-year-old boy was referred for the evaluation and management of painful swelling of the left cheek that had gradually increased in size over a 6 year duration. The examination revealed a palpable firm mass. Reddish-blue buccal mucosa color was observed with an aciniform shape. Preoperative magnetic resonance imaging (MRI) showed a vascular tumor in the left side adjacent to the buccinator and depressor orbicularis oris muscles. Surgical resection under general anesthesia was performed via the intraoral approach. The mass and phleboliths were extracted successfully. A histopathological examination confirmed the diagnosis of IMH. In conclusion, clinicians should be aware of the possibility of IMH in cases of a palpable mass with multiple nodules deep within the muscle in the buccal cheek. Among the several diagnostic tools, MRI provides essential information on the extent and surrounding anatomy of IMH.
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Affiliation(s)
- Jae Woo Park
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University, Cheonan, Korea
| | - Chul-Hwan Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University, Cheonan, Korea
| | - Chan Woong Moon
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University, Cheonan, Korea
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Arts RA, George EL, Griessner A, Zierhofer C, Stokroos RJ. Long-term effects of intracochlear electrical stimulation with looped patterns on tinnitus: A case study. EAR, NOSE & THROAT JOURNAL 2017; 95:E9-E15. [PMID: 27140029 DOI: 10.1177/014556131609504-505] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Electrical stimulation by cochlear implant (CI) has been proven to be a viable treatment option for tinnitus in many recent studies. In addition, intracochlear electrical stimulation independent of an acoustic input appears to suppress tinnitus, at least in the short term. We conducted a case study to investigate the long-term effects of both standard CI and intracochlear electrical stimulation independent of an acoustic input on tinnitus in a patient with single-sided deafness and tinnitus. We found no negative effects of intracochlear electrical stimulation independent of an acoustic input on speech perception in noise. Furthermore, the additional use of a standard CI was advantageous for speech discrimination in our patient. We conclude that long-term tinnitus suppression can be achieved via intracochlear electrical stimulation with looped patterns. Our findings in terms of speech discrimination in our patient were consistent with those reported in previous studies.
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Affiliation(s)
- Remo A Arts
- Department of ENT/Head and Neck Surgery, Maastricht University Medical Centre, P. Debyelaan 25, PO Box 5800, 6202 AZ Maastricht, The Netherlands.
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13
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Kim IK, Seo JH, Cho HY, Lee DH, Jang JM, Kim JM, Park IS. Intramuscular hemangiomas on the masseter muscle and orbicularis oris muscle: a report of two cases. J Korean Assoc Oral Maxillofac Surg 2017; 43:125-133. [PMID: 28462198 PMCID: PMC5410425 DOI: 10.5125/jkaoms.2017.43.2.125] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 09/03/2016] [Accepted: 09/21/2016] [Indexed: 12/18/2022] Open
Abstract
Intramuscular hemangioma (IMH) is a rare vascular disease involving skeletal muscle, comprising only 0.8% of hemangiomas. About 10% to 15% of IMHs occur in the head and neck region, mostly involving the masseter muscle. IMH occurs mostly in childhood, but is often not found until unexpected enlargement, pain, or cosmetic asymmetry occurs in adulthood. Several non-surgical treatments including cryotherapy, sclerosant injection, and arterial ligature have been described, but complete surgical resection is the curative intervention. In this report, we present two rare cases of IMH. One IMH case in a 48-year-old male occurred in the masseter muscle feeding from the transverse facial artery. Embolization of the distal branch of the facial artery was first conducted, and then the buccal mass was removed surgically via the intraoral approach. A second IMH case in a 58-year-old female occurred in the orbicularis oris muscle feeding from the superior labial artery, and the mass was excised surgically without embolization.
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Affiliation(s)
- Il-Kyu Kim
- Department of Oral and Maxillofacial Surgery, Inha University College of Medicine, Incheon, Korea
| | - Ji-Hoon Seo
- Department of Oral and Maxillofacial Surgery, Inha University College of Medicine, Incheon, Korea
| | - Hyun-Young Cho
- Department of Oral and Maxillofacial Surgery, Inha University College of Medicine, Incheon, Korea
| | - Dong-Hwan Lee
- Department of Oral and Maxillofacial Surgery, Inha University College of Medicine, Incheon, Korea
| | - Jun-Min Jang
- Department of Oral and Maxillofacial Surgery, Inha University College of Medicine, Incheon, Korea
| | - Joon Mee Kim
- Department of Pathology, Inha University School of Medicine, Incheon, Korea
| | - In Suh Park
- Department of Pathology, Inha University School of Medicine, Incheon, Korea
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González-Arriagada WA, Santos-Silva AR, Vargas PA, Lopes MA. Diagnostic approach to intramasseteric nodules. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 123:e16-e21. [DOI: 10.1016/j.oooo.2016.10.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Revised: 09/30/2016] [Accepted: 10/08/2016] [Indexed: 10/20/2022]
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15
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Demir Z, Oktem F, Celebioğlu S. Rare Case of Intramasseteric Cavernous Hemangioma in a Three-Year-Old Boy: A Diagnostic Dilemma. Ann Otol Rhinol Laryngol 2016; 113:455-8. [PMID: 15224828 DOI: 10.1177/000348940411300607] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Intramuscular hemangiomas are rare, benign tumors of vascular origin. The masseter is the muscle most commonly involved in the head and neck region. Because of their infrequency, deep location, and unfamiliar presentation, these lesions are seldom correctly diagnosed clinically. This case report presents a severe facial asymmetry caused by a left intramasseteric cavernous hemangioma in a 3-year-old boy. We were unaware of the exact nature of the tumor until intraoperative examination. The routine investigations performed before operation failed to establish a diagnosis. Surgical excision was performed, and 1 year after the operation we observed that the patient's facial asymmetry had been corrected. In this article, we review the literature on intramasseteric hemangioma, discuss the clinical and radiologic diagnostic methods, and review the treatment methods.
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Affiliation(s)
- Zühtü Demir
- Department of Plastic and Reconstructive Surgery, Social Security Foundation Ankara Research Hospital, Ankara, Turkey
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Cheng YT, Lai CC. Transcervical excision of intramasseteric cavernous hemangioma: A case report. Oncol Lett 2016; 11:1657-1660. [PMID: 26998058 PMCID: PMC4774503 DOI: 10.3892/ol.2016.4105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Accepted: 11/23/2015] [Indexed: 11/05/2022] Open
Abstract
Intramuscular hemangiomas (IMHs) of the masseter muscle are extremely rare in the head and neck region and, thus, are often misdiagnosed as parotid tumors prior to surgery. Excisional resection remains the standard treatment for IMH. Since these tumors are located on the proximal side of the facial nerve, it is important to preserve the facial nerve during surgery. This study reports the case of a 57-year-old male who presented with a progressive tender swelling on the right side of the face, which had been present for >6 months. Computed tomography of the neck revealed a heterogeneous highly-vascularized mass located in the superficial layer of the masseter muscle. The patient subsequently underwent surgical resection via a collar incision, and pathological examination revealed a cavernous IMH. During the one-year follow-up period, the patient exhibited a good prognosis, and one-year magnetic resonance imaging revealed no local recurrence.
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Affiliation(s)
- Yu-Ting Cheng
- Department of Otolaryngology, Taipei City Hospital Renai Branch, Taipei City 106, Taiwan R.O.C
| | - Chien-Chung Lai
- Department of Otolaryngology, Taipei City Hospital Renai Branch, Taipei City 106, Taiwan R.O.C.; Department of Otorhinolaryngology, Faculty of Medicine, National Yang-Ming University, Taipei City 102, Taiwan R.O.C
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Konda P, Bavle RM, Makarla S, Muniswamappa S. Intramuscular sinusoidal haemangioma with secondary Masson's phenomenon. BMJ Case Rep 2016; 2016:bcr-2013-201457. [PMID: 26729822 DOI: 10.1136/bcr-2013-201457] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Intramuscular haemangiomas (IMHs) are rare benign vascular neoplasms that account for approximately 0.8% of all haemangiomas. The histology of IMHs can reveal cavernous dilated spaces. We report an interesting case of haemangioma in the deep skeletal muscle of the right labial mucosa in a young man involving the orbicularis oris muscle which showed additional features of sinusoidal arrangement with a secondary Masson's phenomenon.
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Affiliation(s)
- Paremala Konda
- Department of Oral Pathology, Krishnadevaraya College of Dental Sciences, Bangalore, Karnataka, India
| | - Radhika M Bavle
- Department of Oral Pathology, Krishnadevaraya College of Dental Sciences, Bangalore, Karnataka, India
| | - Soumya Makarla
- Department of Oral Pathology, Krishnadevaraya College of Dental Sciences, Bangalore, Karnataka, India
| | - Sudhakara Muniswamappa
- Department of Oral Pathology, Krishnadevaraya College of Dental Sciences, Bangalore, Karnataka, India
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Abstract
ABSTRACT
Intramuscular hemangiomas (IMHs) occur when the proliferation of blood vessels is found between the skeletal muscle fibers, and they account for less than 1% of all hemangiomas. We report two cases of IMHs in the rare locations like tongue and temporalis muscle. These hemangiomas should be considered in a differential diagnosis of the soft tissue masses. Radiology plays a pivotal role in the diagnosis of these lesions.
How to cite this article
Kamra S, Pai KM, Chhaparwal Y. Intramuscular Hemangioma: Enigmatic Dilemma in Diagnosis. J Health Sci Res 2016;7(2):67-70.
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Abstract
Hemangiomas are frequent benign hereditary vascular tumors. Intramuscular hemangiomas, a distinctive type of hemangioma occurring within the skeletal muscle, account for less than 1% of all hemangiomas. They occur more often in the trunk and extremity muscles, whereas the involvement of the temporal muscle is extremely rare. A 34-year-old man with a mass in his left temporal fossa was admitted. Computed tomographic scan showed no erosion of the bone, and magnetic resonance imaging revealed an ovoid mass within the temporal muscle. The lesion was surgically excised, and histopathologic examination confirmed the diagnosis of cavernous hemangioma. The patient was not able to lift his left eyebrow right after the surgery. Two months after the surgery, the patient recovered from paralysis, and there was no recurrence of tumor 12 months after the surgery. We report the 27th cavernous hemangioma case of the temporalis muscle. Care must be taken to avoid possible stretch injury to facial nerve branches while resecting these tumors.
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A Case of Cavernous Hemangioma in the Submandibular Gland: A Review of Clinicoradiologic Features and Treatment Methods. ACTA ACUST UNITED AC 2015. [DOI: 10.3342/kjorl-hns.2015.58.10.699] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Romano A, Tavanti F, Rossi Espagnet MC, Terenzi V, Cassoni A, Suma G, Boellis A, Pierallini A, Valentini V, Bozzao A. The role of time-resolved imaging of contrast kinetics (TRICKS) magnetic resonance angiography (MRA) in the evaluation of head-neck vascular anomalies: a preliminary experience. Dentomaxillofac Radiol 2014; 44:20140302. [PMID: 25410709 DOI: 10.1259/dmfr.20140302] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES In this preliminary report, we describe our experience with time-resolved imaging of contrast kinetics-MR angiography (TRICKS-MRA) in the assessment of head-neck vascular anomalies (HNVAs). METHODS We prospectively studied six consecutive patients with clinically suspected or diagnosed HNVAs. All of them underwent TRICKS-MRA of the head and neck as part of the routine for treatment planning. A digital subtraction angiography (DSA) was also performed. RESULTS TRICKS-MRA could be achieved in all cases. Three subjects were treated based on TRICKS-MRA imaging findings and subsequent DSA examination. In all of them, DSA confirmed the vascular architecture of HNVAs shown by TRICKS-MRA. In the other three patients, a close follow up to assess the evolution of the suspected haemangioma was preferred. CONCLUSIONS TRICKS sequences add important diagnostic information in cases of HNVAs, helpful for therapeutic decisions and post-treatment follow up. We recommend TRICKS-MRA use (if technically possible) as part of routine MRI protocol for HNVAs, representing a possible alternative imaging tool to conventional DSA.
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Affiliation(s)
- A Romano
- 1 San Raffaele Foundation Rome, Rehabilitation Facility Ceglie Messapica, Rome, Italy
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Masseteric intramuscular hemangioma: case report. J Oral Maxillofac Surg 2014; 72:2192-6. [PMID: 24976110 DOI: 10.1016/j.joms.2014.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Revised: 06/02/2014] [Accepted: 06/03/2014] [Indexed: 11/22/2022]
Abstract
Securing a clinical diagnosis for the masseteric intramuscular hemangioma is difficult. However, making a diagnosis can be facilitated with imaging, particularly magnetic resonance imaging, which serves as a key element in preoperative diagnosis.
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Intramuscular capillary-type hemangioma: radiologic-pathologic correlation. Pediatr Radiol 2014; 44:558-65. [PMID: 24487677 DOI: 10.1007/s00247-014-2876-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Revised: 11/08/2013] [Accepted: 01/06/2014] [Indexed: 12/27/2022]
Abstract
BACKGROUND Infantile hemangiomas demonstrate a pattern of proliferative growth in infancy followed by a slow phase of involution. In contrast a rare type of vascular tumor, intramuscular capillary-type hemangioma, usually presents beyond the period of infancy with nonspecific symptoms and no evidence of involution. OBJECTIVE The purpose of this study was to characterize the clinical, imaging, histopathological characteristics and management of intramuscular capillary-type hemangioma. MATERIALS AND METHODS We performed a retrospective review of a 20-year period to identify children diagnosed with intramuscular capillary-type hemangioma. Patient demographics, imaging and histopathological findings were recorded. RESULTS We included 18 children (10 boys, 8 girls) with histologically proven intramuscular capillary-type hemangioma - and adequate imaging. The mean age at presentation was 8.1 years (range 1 day to 19 years). Twelve lesions involved muscles of the extremities, 4 were located in the trunk and 2 were in the head and neck. MRI had been performed in all children and demonstrated a soft-tissue mass with flow voids, consistent with fast flow. The lesion was well-circumscribed in 16 children and intralesional fat was seen in 14. Doppler US demonstrated a heterogeneous lesion, predominantly isoechoic to surrounding muscle, with enlarged arterial feeders. Enlarged feeding arteries, inhomogeneous blush and lack of arteriovenous shunting were noted on angiography (n = 5). The most common histopathological findings were lobules of capillaries with plump endothelium and at least some adipose tissue. The lesions were excised in six children. Two children were lost to follow-up. In the remaining 10, follow-up MRI studies ranging from 3 months to 10 years showed that the lesion enlarged in proportion to the child (n = 7), demonstrated slow growth (n = 2) or remained stable (n = 1). There was no change in imaging characteristics on follow-up. CONCLUSION Intramuscular capillary-type hemangioma is a rare benign vascular tumor of skeletal muscle. The most typical imaging features show a heterogeneous intramuscular mass with fast flow, and intralesional fat. Although the lesion is relatively stable in appearance over time, imaging does not obviate the need for a biopsy to rule out sarcoma. The diagnosis can usually be established by typical findings on histopathology.
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Abukawa H, Watanabe M, Asada Y, Satomi T, Matsuo A, Chikazu D. Ultrasound-guided intralesional photocoagulation of intramuscular vascular malformation in the masseter muscle. J Oral Maxillofac Surg 2012; 70:2674-9. [PMID: 22364856 DOI: 10.1016/j.joms.2011.12.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Revised: 12/26/2011] [Accepted: 12/30/2011] [Indexed: 11/26/2022]
Affiliation(s)
- Harutsugi Abukawa
- Department of Oral and Maxillofacial Surgery, Tokyo Medical University, Tokyo, Japan.
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Venous hemangioma of parapharyngeal space with calcification. Clin Exp Otorhinolaryngol 2011; 4:207-9. [PMID: 22232718 PMCID: PMC3250587 DOI: 10.3342/ceo.2011.4.4.207] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2009] [Revised: 10/19/2009] [Accepted: 10/22/2009] [Indexed: 12/02/2022] Open
Abstract
A hemangioma of the parapharyngeal space (PPS) is an extremely rare tumor and is responsible for 0.5-1% of all tumors occurring in the PPS. We report a case of PPS venous hemangioma in a 49-year-old woman presenting with diffuse swelling in the submandibular region. A preoperative computed tomography (CT) scan showed a cystic mass with multiple calcifications in the PPS. The calcific nodules were round and about 2 mm in diameter. The hemangioma was completely resected via a transcervical approach. During surgery, we found several calcific nodules, which represented phleoboliths or areas of thrombosis with dystrophic calcification. Despite its rarity, a venous hemangioma of the PPS should be considered in a differential diagnosis when a cystic mass with calcification is found by CT scan. To our knowledge, this is the first reported case of a PPS venous hemangioma; we describe its pathognomonic findings on imaging.
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Silva VA, Lima NL, Mesquita ATM, da Silveira EM, Verli FD, de Miranda JL, Santos CRR, Marinho SA. Intramuscular hemangioma in lip treated with sclerotherapy and surgery. Case Rep Dent 2011; 2011:302451. [PMID: 22567433 PMCID: PMC3335477 DOI: 10.1155/2011/302451] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2011] [Accepted: 06/12/2011] [Indexed: 11/20/2022] Open
Abstract
Intramuscular hemangioma is a relatively rare, benign tumor of vascular origin, accounting for less than 1% of all hemangiomas. This paper reports a case of a 48-year-old female patient with intramuscular hemangioma in the upper lip, treated with sclerotherapy and subsequent complementary surgery.
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Affiliation(s)
- Vanessa A. Silva
- School of Dentistry, Federal University of Jequitinhonha and Mucuri Valleys (UFVJM), 39100-000 Diamantina, MG, Brazil
| | - Nádia L. Lima
- Laboratory of Pathology, Department of Basic Sciences, Federal University of Jequitinhonha and Mucuri Valleys (UFVJM), 39100-000 Diamantina, MG, Brazil
| | - Ana Terezinha M. Mesquita
- Laboratory of Pathology, Department of Basic Sciences, Federal University of Jequitinhonha and Mucuri Valleys (UFVJM), 39100-000 Diamantina, MG, Brazil
- Stomathology Clinics, School of Dentistry, Federal University of Jequitinhonha and Mucuri Valleys (UFVJM), 39100-000 Diamantina, MG, Brazil
| | - Esmeralda Maria da Silveira
- Stomathology Clinics, School of Dentistry, Federal University of Jequitinhonha and Mucuri Valleys (UFVJM), 39100-000 Diamantina, MG, Brazil
| | - Flaviana D. Verli
- Laboratory of Pathology, Department of Basic Sciences, Federal University of Jequitinhonha and Mucuri Valleys (UFVJM), 39100-000 Diamantina, MG, Brazil
| | - João Luiz de Miranda
- Laboratory of Pathology, Department of Basic Sciences, Federal University of Jequitinhonha and Mucuri Valleys (UFVJM), 39100-000 Diamantina, MG, Brazil
| | - Cássio Roberto R. Santos
- Stomathology Clinics, School of Dentistry, Federal University of Jequitinhonha and Mucuri Valleys (UFVJM), 39100-000 Diamantina, MG, Brazil
| | - Sandra A. Marinho
- Stomathology Clinics, School of Dentistry, Federal University of Jequitinhonha and Mucuri Valleys (UFVJM), 39100-000 Diamantina, MG, Brazil
- Post Graduate Program in Dentistry, Federal University of Jequitinhonha and Mucuri Valleys (UFVJM), Rua da Glória 187, 39100-000 Diamantina, MG, Brazil
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Phleboliths and the Vascular Maxillofacial Lesion. J Oral Maxillofac Surg 2010; 68:1973-6. [DOI: 10.1016/j.joms.2010.04.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2008] [Revised: 02/08/2010] [Accepted: 04/04/2010] [Indexed: 11/21/2022]
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Kim HW, Kil TJ, Choi JM, Nam W, Cha IH, Kim HJ. Intramuscular hemangioma formation in the masseter muscle: a case report. J Korean Assoc Oral Maxillofac Surg 2010. [DOI: 10.5125/jkaoms.2010.36.5.423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Hyun-Woo Kim
- Department of Oral and Maxillofacial Surgery, College of dentistry, Yonsei University, Seoul, Korea
| | - Tae-Jun Kil
- Department of Oral and Maxillofacial Surgery, College of dentistry, Yonsei University, Seoul, Korea
| | - Jong-Myung Choi
- Department of Oral and Maxillofacial Surgery, College of dentistry, Yonsei University, Seoul, Korea
| | - Woong Nam
- Department of Oral and Maxillofacial Surgery, College of dentistry, Yonsei University, Seoul, Korea
| | - In-Ho Cha
- Department of Oral and Maxillofacial Surgery, College of dentistry, Yonsei University, Seoul, Korea
| | - Hyung-Jun Kim
- Department of Oral and Maxillofacial Surgery, College of dentistry, Yonsei University, Seoul, Korea
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Skoulakis CE, Khaldi L, Serletis D, Semertzidis T. A Hemangioma on the Floor of the Mouth Presenting as a Ranula. EAR, NOSE & THROAT JOURNAL 2008. [DOI: 10.1177/014556130808701109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A painless, bluish, submucosal swelling on one side of the floor of the mouth usually indicates the presence of a ranula. Rarely, such a swelling may be caused by an inflammatory disease process in a salivary gland, a neoplasm in the sublingual salivary gland, a lymphatic nodular swelling, or embryologic cysts. We report a patient with swelling in the floor of her mouth that was clinically diagnosed as a ranula. Suspicion arose during surgery that it was a vascular tumor and, on histologic testing, the swelling was confirmed to be a hemangioma. To our knowledge, this is the first report in the literature of a hemangioma presenting as ranula.
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Affiliation(s)
| | - Lubna Khaldi
- Department of Pathology, University of Thessaly School of Medicine, Larissa, Greece
| | - Demetre Serletis
- Department of Otolaryngology, University of Thessaly School of Medicine, Larissa, Greece
| | - Themistoklis Semertzidis
- Department of Oral and Maxillofacial Surgery, University of Thessaly School of Medicine, Larissa, Greece
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Capote A, Acero J, García-Recuero I, Rey J, Guerra B, de Paz V. Infratemporal-Preauricular-Cervical Approach for Resection of a Cavernous Intramasseteric Hemangioma: A Case Report. J Oral Maxillofac Surg 2008; 66:2393-7. [PMID: 18940514 DOI: 10.1016/j.joms.2007.06.650] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2006] [Revised: 11/28/2006] [Accepted: 06/06/2007] [Indexed: 11/15/2022]
Affiliation(s)
- Ana Capote
- Oral and Maxillofacial Surgery, Oral and Maxillofacial Institute Dr Julio Acero, Madrid, Spain.
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Kang GCW, Song C. Forty-one Cervicofacial Vascular Anomalies and Their Surgical Treatment –
Retrospection and Review. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2008. [DOI: 10.47102/annals-acadmedsg.v37n3p165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Introduction: Haemangiomas in children usually involute spontaneously and surgical treatment is exceptional. Vascular malformations do not regress spontaneously and resection may become necessary. We present a series of surgically treated face and neck vascular anomalies during a 9-year period, assessing the epidemiology, presenting signs and symptoms, diagnostic modalities, indications for surgery, treatment methods and clinical outcome post-treatment.
Materials and Methods: The medical and pathological records of all patients with cervicofacial vascular anomalies treated surgically at our department from 1997 to 2005 were retrospectively reviewed in relation to current evidence.
Results: Forty-one patients were identified. Of these, 9 patients had haemangiomas and the remaining 32 had a variety of vascular malformations. Cervicofacial vascular anomalies were most commonly located at the lip. Atypical looking vascular anomalies like masseteric intramuscular haemangiomas and parotid malformations were diagnostic problems. All 41 had surgical excision of their vascular anomalies for troubling symptoms, cosmesis or diagnostic purpose. For cervicofacial arteriovenous malformations, 28% were classified as Schobinger stage I, 50% stage II, and the remainder stage III. Combined embolisation-resection was used to treat 6 arteriovenous malformations (stage II to III) and of these, 3 required flap reconstruction.
Conclusions: Accurate diagnosis distinguishing between cervicofacial haemangiomas and vascular malformations is key to best treatment. The diagnosis can usually be made by history and physical examination aided by early magnetic resonance imaging (MRI). Although cervicofacial haemangiomas can be managed conservatively or with medical therapy, surgery is indicated for preventing psychological distress and in cases of chronic aesthetic alteration resulting from partial regression. Aesthetic concerns and prevention of psychosocial distress point to early excision of venous malformation as the treatment of choice. Lymphatic malformations are best treated by excision. Outcome after excision of localised cervicofacial haemangiomas and low-flow vascular malformations is excellent. Large extensive low-flow malformations as well as those located at the lips may require multiple procedures including reconstruction; patients should be informed that the outcome is generally not as good. Combined embolisation-resection is definitive treatment for arteriovenous malformations and flap reconstruction may prevent their recurrence. Tissue expansion is a useful reconstructive tool after the excision of large vascular anomalies.
Key words: Face and neck, Haemangioma, Single institution outcome, Vascular malformation
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Boricić I, Stojsić Z, Mikić A, Brasanac D, Tomanović N, Bacetić D. Intramuscular hemangioma of the retropharyngeal space. VOJNOSANIT PREGL 2007; 64:485-8. [PMID: 17821925 DOI: 10.2298/vsp0707485b] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Intramuscular hemangioma (IMH) is a distinctive type of hemangioma occurring within skeletal muscle. Most IMH are located in the lower extremity, particularly in the muscles of the thigh. When present in the head and neck region, the masseter and trapezius muscle are the most frequently involved sites. CASE REPORT We reported a case of unusual localization of the head and neck IMH occurring within the retropharyngeal space (RPS). To our knowledge, this is the second such case reported in the English literature. The tumor presented as a left-sided neck mass with bulging of the posterior and left lateral oropharyngeal wall on indirect laryngoscopy. Computed tomography (CT) scan revealed an ill-defined mass in the RPS at the oropharyngeal level. The lesion was excised via a transoral approach and microscopically diagnosed as IMH, the complex malformation subtype. Although surgical margins were positive, no recurrence of the tumor was noted in the 17-month follow-up. CONCLUSION Intramuscular hemangioma should be considered in the differential diagnosis of deep head and neck masses. The knowledge of the infiltrative nature and recurrence rate of an IMH is useful for appropriate managment.
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Affiliation(s)
- Ivan Boricić
- University of Belgrade, School of Medicine, Institute of Otorhinolaryngology, Belgrade.
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Moumoulidis I, Durvasula VS, Jani P. An unusual neck lump: intramuscular haemangioma of the sternocleidomastoid muscle. Eur Arch Otorhinolaryngol 2007; 264:1257-60. [PMID: 17593381 DOI: 10.1007/s00405-007-0372-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2006] [Accepted: 02/09/2007] [Indexed: 10/23/2022]
Abstract
Neck lumps can often present a diagnostic dilemma, with a wide pre-operative differential diagnosis. We present an unusual case of an intramuscular haemangioma arising in the sternocleidomastoid muscle. Pre operative diagnosis is often difficult, as these lesions are extremely rare in the head and neck region and only few sporadic cases have been reported in the literature. We report the presentation diagnosis and management of intramuscular haemangiomas of the sternocleidomastoid muscle.
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Affiliation(s)
- I Moumoulidis
- Department of Otolaryngology-Head and Neck Surgery, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK.
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Lee SK, Kwon SY. Intramuscular cavernous hemangioma arising from masseter muscle: a diagnostic dilemma (2006: 12b). Eur Radiol 2007; 17:854-7. [PMID: 17225132 DOI: 10.1007/s00330-006-0448-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2006] [Revised: 07/18/2006] [Accepted: 08/11/2006] [Indexed: 10/23/2022]
Abstract
We report here a case of intramuscular cavernous hemangioma of the right masseter muscle in a 41-year-old woman-misdiagnosed preoperatively as parotid tumor-along with its imaging and pathologic findings. Preoperative diagnosis of intramuscular cavernous hemangiomas of the masseter muscle is problematic, in that they may be confused with parotid tumor or other muscular lesions. In a patient with soft-tissue mass suspected of representing a hemangioma, MR imaging may provide more specific information regarding the characteristics, the origin, and the extent of the lesion than other imaging modalities.
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Affiliation(s)
- Sang Kwon Lee
- Department of Diagnostic Radiology, Dongsan Medical Center, Keimyung University College of Medicine, 194 Dongsan-dong, Jung-gu, Daegu, 700-712, South Korea.
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Mandel L, Surattanont F. Clinical and imaging diagnoses of intramuscular hemangiomas: the wattle sign and case reports. J Oral Maxillofac Surg 2004; 62:754-8. [PMID: 15170294 DOI: 10.1016/j.joms.2003.05.022] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Louis Mandel
- Salivary Gland Center, Columbia University School of Dentistry and Oral Surgery, New York-Presbyterian Hospital, NY 10032, USA.
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Danielides V, Nousia CS, Achten E, Forsyth R, Vermeersch H. Hemangioma of the left cheek: a case report. Otolaryngol Head Neck Surg 2003; 128:430-2. [PMID: 12646850 DOI: 10.1067/mhn.2003.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Vasilis Danielides
- Department of Otorhinolaryngology, University of Ioannina Medical School, Greece.
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Abstract
More than half of the patients with vascular anomalies referred to the Vascular Anomalies Clinic at Children's Hospital, Boston, have been misdiagnosed. A major consequence of misdiagnosis is inappropriate treatment, including deferral of necessary treatment and inappropriate use of pharmacotherapy, radiation, surgery, and embolotherapy. Hemangiomas and vascular malformations are distinct categories with completely different biologic and clinical behavior, therapeutic requirements, and imaging features. This article reviews the biologic classification of vascular anomalies and corresponding MR imaging features, and presents a simplified guide to diagnosis.
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Affiliation(s)
- Orhan Konez
- Division of Cardiovascular and Interventional Radiology, Department of Radiology, Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA
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