The role of fine-needle aspiration biopsy in the diagnosis and management of juvenile hemangioma of the parotid gland and cheek

Three Cases of Parotid Hemangiomas in Adults

Hemangiomas account for only 0.4% to 0.6% of all parotid tumors, making them extremely rare in adults. Unlike pediatric parotid hemangiomas, those in adults typically present as asymptomatic swellings of the parotid, have no skin discoloration, and usually do not regress spontaneously. Therefore, an accurate diagnosis of parotid hemangiomas in adults before surgical excision is generally challenging. Herein, we present 3 cases of adult parotid hemangiomas. The patients all received parotidectomies with tumor resection. Histopathological analysis of the resected specimens revealed numerous dilated, thin- or thick-walled (small, large, or variably sized) vessels lined with flattened endothelial cells. A diagnosis of cavernous hemangioma of the parotid gland was established only after the histopathological analysis. Parotid cavernous hemangiomas in adults are rare and often misdiagnosed before surgical resection. Clinical presentation and imaging features on ultrasonography, computed tomography, magnetic resonance imaging, and angiography may support an accurate preoperative diagnosis. Surgical resection proved a suitable treatment approach for our 3 cases.

Cytological diagnosis of deep-seated cellular hemangioma of the parotid gland by using cell button technique

Intraparotid hemangioma of the children is a rare neoplasm, posing diagnostic dilemma to the diagnosticians as well as treating clinicians. A 2-month-old male infant presented with a diffuse swelling in the parotid region since birth that was gradually increasing in size. The ultrasonography (USG) report was suggestive of a right intraparotid mass of uncertain etiology; whereas magnetic resonance imaging (MRI) report inclined toward a mass associated with chronic inflammatory pathology. Fine-needle aspiration cytology (FNAC) suggested two differentials - a vascular neoplasm of the parotid gland and a spindle cell neoplasm with increased vascularity. The lesion was reaspirated and a cell button was constructed from the aspirated material to reach a conclusive diagnosis by histopathological evaluation and immunohistochemistry (IHC) before attempting any intervention to treat the infant. The final diagnosis after histopathological and IHC studies was given as deep cellular intraparotid hemangioma. Subsequently, the patient was treated with single sitting bleomycin sclerotherapy. A simple technique of cell button resulted in sparing of hospitalization and surgical procedure in the infant.

A cavernous hemangioma of the thyroid gland: First documentation by ultrasound of a rare pathology

Hemangioma of the thyroid gland is an extremely rare condition. We report a case of a primary cavernous hemangioma in the left lobe of the thyroid gland in an 84-year-old woman. Ultrasound examination of the lesion showed an inhomogeneous and hypoechoic nodule that was well demarcated from the rest of the left lobe and hypovascular on color Doppler ultrasound. Ultrasound-guided fine-needle aspiration was performed. The cytologic differential diagnosis included an anaplastic carcinoma of the thyroid gland. After hemithyroidectomy, the final diagnosis was a benign hemangioma of the thyroid gland.