Infratemporal-Preauricular-Cervical Approach for Resection of a Cavernous Intramasseteric Hemangioma: A Case Report

Conventional Radiology in Deep Seated Facial Hemangioma: A Case Report

Hemangioma is congenital or traumatic in origin, and it is caused due to atypical build-up of the blood vessel. It is a painless benign condition with typical characteristic clinical features. These generally occur in the first three decades of life with no gender predispositions. A plain soft tissue radiograph can demonstrate phleboliths and aid in diagnosing an intramuscular hemangioma. The present report is a rare deep-seated facial hemangioma involving various facial muscles with multiple phleboliths; characteristics clinical and radiological features. A 22-year-old male patient reported a complaint of swelling on the right side of the jaw. Conventional radiography showed the right cheek's soft tissue and multiple round, target-like radiopacities of variable sizes.

Masseteric intramuscular hemangioma: case report

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.

A case of subcutaneous hemangioma presenting as a preauricular sinus

Hemangioma is one of the most common benign neoplasm involved on head and neck. However, cavernous hemangiomas are relatively rare in preauricular sinus space and has rarely been reported around the world. Recently, a 44-year-old female patient came to our clinic with cavernous hemangioma involving the preauricular sinus. This case was surgically managed via excision. Preoperatively, it was difficult to differentiate the mass of hemangioma clinically and diagnostically from a preauricular fistula, a salivary gland tumor, or an enchondroma. This case report describes the subcutaneous hemangioma on a preauricular sinus, which is rarely seen in Korea. The clinical presentation and management are discussed with a review of the literature.

Intramuscular cavernous hemangioma arising from the masseter muscle

INTRODUCTION

Only 10% of intramuscular hemangiomas (IMH) are located in the head and neck region. There are very few reports of masseteric location. The present study of a case of intra-masseteric cavernous hemangioma discusses clinical presentation, paraclinical diagnostic workup and treatment options.

CASE REPORT

A 70-year-old male patient consulted for a swelling of 2 years' evolution, anterior to the left parotid gland. The swelling was firm, painless, well-contoured, oblong, 3 cm on its long axis, and located in the masseter muscle. There was no effect of head position on tumor volume. MRI showed a vascular tumor. Surgical resection was performed via parotidectomy. There were no postoperative complications. Pathological examination confirmed the diagnosis of cavernous hemangioma.

DISCUSSION

Head and neck IMH is commonly located in the masseter muscle. Evolution is slow. Size is variable, contours are well defined and the surface is smooth. MRI is essential ahead of treatment, which is surgical on an external or intra-oral approach.

Surgical management of head and neck vascular anomalies in children: a retrospective analysis of 42 patients

OBJECTIVE

This article aimed to present a series of surgically treated head and neck vascular anomalies during a 12-year period, highlighting the epidemiology, diagnostic approach, indications for surgery, and final clinical outcome.

STUDY DESIGN

The medical records of all patients with head and neck vascular anomalies, surgically treated at our department from 1998 to 2010, were reviewed retrospectively.

RESULTS

A total of 42 patients with 46 vascular anomalies were identified. Patients' diagnoses included vascular tumors, hemangiomas mainly (18 cases), and various vascular malformations (26 cases). All patients were submitted to surgical treatment (excision-resection) to resolve main clinical symptoms (ulceration, bleeding, impaired mastication and feeding, airway obstruction) and/or esthetic issues. Recurrence was noted in 3 patients.

CONCLUSION

Accurate differential diagnosis based on history, physical examination, and imaging, is the key to optimal treatment. Surgical intervention is warranted for small to moderately extended lesions to avoid complications and/or esthetic concerns and psychosocial distress.

[Intramasseteric hemangioma operated by intraoral approach]

INTRODUCTION

Hemangiomas are benign vascular tumors, of unknown origin. Skeletal muscle localization account for less than 1% of cases. Masseter muscle localization is most common in head and neck (36%). In this case, treatment is usually surgery via an extra-oral approach which imposes parotidectomy with dissection of facial nerve branches. We report a case of intramasseteric hemangioma operated via an intraoral approach and we describe the benefits of this approach.

CASE REPORT

A 34-year-old male patient with no prior history of trauma consulted for left masseter swelling having evolved for several years. Clinical examination revealed a soft, painless, well-defined swelling, about 5cm long, with a positive Wattle sign in the left cheek. The CT exam suggested a vascular lesion, located in the deep bundle of the masseter muscle. Preoperative embolization was followed by surgical exeresis via an intraoral approach. The post-operative evolution was uneventful. No recurrence was observed at one year of follow-up.

DISCUSSION

Intraoral intramasseteric hemangioma exeresis is possible and does not seem to lead to more complications than with the facial approach. It prevents the significant drawbacks due to cutaneous incision, parotidectomy, and dissection of facial nerve branches via a facial approach.