Bilateral Masseter and Internal Pterygoid Muscle Hypertrophy: A Diagnostic Challenge

To describe an unusual case of bilateral masseter and pterygoid muscle hypertrophy.

A 23-year-old male patient presented with a bilateral, painless swelling of 1 year duration at the parotid areas without improvement after using antibiotics/systemic corticosteroids/non steroidal anti-inflammatory agents. His medical history was not significant. The initial differential diagnosis included salivary gland/jaw bone/masseter pathology, but the MRI revealed only an increase in the size of the masseter and pterygoid muscles. The patient was informed of the benign nature of the swelling and was advised to discontinue the use of non steroidal anti-inflammatory agents.

The bilateral hypertrophy of masseter muscles should be considered in differential diagnosis in cases of unilateral or bilateral swelling of the parotid or lateral mandible area.