Masseter and medial pterygoid muscle hypertrophy

Hypertrophy refers to an enlargement caused by an increase in the size but not in the number of cells. Generalised masticatory muscle hypertrophy may affect the temporalis muscle, masseters and medial pterygoids in a variety of combinations. Masseteric hypertrophy may present as either unilateral or bilateral painless swelling of unknown origin in the region of angle of mandible. It is a relatively rare condition and presents a diagnostic dilemma. While the history and clinical examination are important in differentiating this benign condition from parotid or dental pathology, they cannot necessarily exclude rare malignant lesion within the muscle. Advanced imaging modalities like CT and MRI are essential to confirm the diagnosis. Here the authors are reporting a unique case of masseter muscle hypertrophy along with medial pterygoid hypertrophy which was missed clinically but confirmed using CT and MRI.