A Clinical Observation to Diagnose Parotid Hemangioma

Abstract

A clinical observation to diagnose parotid hemangioma is presented in this article. A hemangioma can be made to distend by blocking its venous outflow. If a distended hemangioma is located within the parotid gland, it stretches the parotid capsule. Thus application of pressure over parotid venous outflow causes the hemangioma to bulge, thereby stretching the parotid capsule. It makes the outline of the gland clinically apparent. This observation is useful to differentiate a hemangioma present in the parotid gland from one that is placed outside the gland like an intramuscular hemangioma of the masseter muscle or internal jugular phlebectasia.

Parotid Hemangioma: Case Report

“…The sign is demonstrable in >50% cases (3) . Reddi's sign is a less known feature wherein the compression of the external and internal jugular veins causes the swelling to become more prominent due to obstruction to venous outflow (4) .…”

Cavernous Haemangioma of the Parotid Gland in Adults: A Review of the Literature & Case Report

“…Although, it is very rare to observe bluish discoloration of the skin with cavernous hemangioma, which is a characteristic feature of benign hemangioendothelioma [21]. The tumor expands slowly but sometimes sudden increase in size can lead to compression of vital structures especially at later stage [22].…”

“…Although they are typically slow flow lesions and may not be angiographically evident [17]. Cavernous hemangiomas in adults does not regress [1,15], and they tend to have a chronic course and a slowly progressive growth unlike pediatric one [1,25] The presence of radiological radio-opacities phleboliths is very suggestive of hemangioma or vascular malformation (cavernous hemangioma in particular) [1,4,10,15,17,21].…”

“…Redid BR et al [21] even stated that the presence of calcified phleboliths on radiological imaging is a characteristic finding of cavernous hemangioma of the salivary gland [26], although cavernous hemangioma with multiple phleboliths are very rare [1,4,17]. However, these only occur in 2-3% of cases and it should be differentiated from sialoliths and other cause of head and neck calcifications by a sialography [1,4,10,25].…”

“…The clinical examination to diagnose parotid hemangioma is Turkey-Wattle Sign. If the hemangioma lies outside the gland, there will not be any increase in the size [4,10,21,22,27]. Dempsey et al [27] described this specific clinical sign, was found in 50% of their patients.…”