Management of intramuscular venous malformations of the masseter muscle

Less than 1% of vasoformative tumours throughout the body occur in skeletal muscle and 15% of them arise in head and neck musculature. The masseter muscle is the most frequent site and accounts for approximately 5% of all intramuscular vascular malformations in the head and neck region. Masseteric venous malformations have a typical clinical presentation and imaging characteristics that should allow clinicians to distinguish them from other abnormalities presenting in this area. We present seven cases of these unusual intramasseteric venous malformations and the diagnosis and management of these lesions is discussed. The diagnosis was made on clinical grounds and was confirmed on MRI. All underwent surgical excision through a facelift approach and were successfully removed from within the substance of the masseter muscle with preservation of the facial nerve. Venous malformations within the masseter are rare but are easy to diagnose and can be reliably surgically excised without complications.