Computed tomography in the diagnosis of buccal space masses

To evaluate the CT features of buccal space masses.

Fifty-three cases of buccal space masses were reviewed retrospectively. The diagnosis was confirmed histopathologically in all except two. CT images were assessed for the number, location, internal architecture and margin of the lesions and their relation to the surrounding structures.

The series comprised 44 tumors (33 benign and 11 malignant) and nine non-tumorous lesions. Buccal gland tumors were all found adjacent to the outer surface of the buccinator, in contrast to epidermoid cysts and accessory parotid tumors which were completely separate from it. Hemangiomas were characterized by multiple masses or the presence of phleboliths. When ill-defined margins, violation of fascial planes and aggressive bone destruction were used as the criteria for the malignancy, only seven out of 11 malignant tumors were correctly diagnosed (sensitivity 64%).

CT was useful in demonstrating the presence and location of the masses in the buccal space and sometimes in the differential diagnosis. For a mass of uncertain cause in the buccal space, a buccal gland tumor is the most likely diagnosis. The value of CT in differentiating malignant from benign buccal space lesions is limited.