Cavernous hemangioma of the temporal muscle

Intramuscular cavernous hemangiomas are often found in the brain, but they are uncommon in the muscles of the head and neck region, with the masseter being the most frequent, followed by the trapezius and sternocleidomastoideus. Such a lesion in the temporal muscle is an extremely unusual situation. A 55-year-old man presented with intermittent headaches and painless swelling of the right temple region brought on by stress and bending forward. On MRI, T1-weighted imaging with enhancement after contrast medium showed a low signal-intense, fat-free lesion restricted to the temporal muscle. T2 weighting showed a hyperintense, high fluid content, low-flow lesion. There was no progression within 2 years. No resection was performed. In planning a treatment approach, one must bear in mind that cavernous hemangiomas in the temporal muscle or other muscles of the head and neck can be clinically distinguished from the more aggressive capillary ones. Complications are extremely rare (hemorrhage or functional deficits). These cavernomas should simply be followed up and only resected in case of any problems (cosmetic, neurological deficits).