Intramuscular hemangioma of the masseter muscle:a case report

ABSTRACT

Background - Intramuscular hemangiomas are benign vascular tumours that most frequently occur in the trunk and extremities.They constitute about <1% of all hemangiomas, only 10%–20% have been found to arise in the head and neck region, and 36% of cases involving masseter muscle.They usually present as gradually enlarging soft-tissue mass with or without pain. They are located deep within the muscle, hence rarely exhibit clinical signs or symptoms such as bruits, thrills, pulsation which are suggestive of vascular origin. Due to their rare occurrence, unique location they are often confused with other soft-tissue pathologies such as parotid swelling or other muscular lesions. Case report - 21 year old male came with complaints of swelling and pain over the left cheek for past 6 months which was insidious in onset and non progressive.Patient did not have any history of trauma or increased salivation.On examination swelling of about 2*2 cm over the left cheek,well defined,non tender,soft in consistency.There was no pulsation,bruits or palpable thrill.There was no compressibility and the overlying skin was normal.There was no facial nerve involvement and parotid duct orifice was normal. Conclusion - The possibility of an Intramuscular hemangioma of the masseter muscle should be included in the differential diagnosis of any intra-masseteric lesion. Appropriate radiologic examinations, especially MRI, can enhance accurate preoperative diagnosis; the treatment of choice should be individualized in view of the clinical status of the patient.