Intramuscular cavernous hemangioma arising from the masseter muscle

Area of Science:

• Vascular Tumors
• Head and Neck Surgery
• Diagnostic Imaging

Background:

• Intramuscular hemangiomas (IMH) are uncommon in the head and neck, accounting for only 10% of cases.
• Intra-masseteric location of IMH is exceptionally rare, with limited case reports available.
• This study details a rare case of intra-masseteric cavernous hemangioma, focusing on its clinical aspects, diagnosis, and management.

Observation:

• A 70-year-old male presented with a 2-year history of a firm, painless, well-defined, oblong swelling in the left masseter muscle.
• The swelling measured 3 cm along its long axis and was located anterior to the parotid gland.
• Magnetic Resonance Imaging (MRI) confirmed the presence of a vascular tumor within the masseter muscle.

Findings:

• Surgical resection via parotidectomy was successfully performed with no postoperative complications.
• Pathological examination definitively diagnosed the mass as a cavernous hemangioma.
• The masseteric IMH exhibited slow evolution, variable size, well-defined contours, and a smooth surface.

Implications:

• MRI is crucial for the accurate diagnosis of intra-masseteric hemangiomas prior to treatment.
• Surgical intervention, utilizing either external or intra-oral approaches, is the primary treatment modality.
• Understanding the characteristics of masseteric IMH aids in surgical planning and patient management for this rare condition.