Fluctuant Facial Mass

Abstract

We thank the patient for granting permission to publish this information.

Intraparotid facial varix

“…The options include observation, the injection of sclerosing agents, and surgical excision. 1 , 2 , 6 The symptoms of the patient could direct care toward operative or nonoperative management. Surgical exploration and resection have historically been performed owing to the ease of exposure and the decreased likelihood of recurrence.…”

“…Facial varices are dilated, thin-walled, tortuous veins that arise secondary to weakening of the venous wall or a distal obstruction. 1 , 2 They are rare clinical entities, as evidenced by the paucity of existing reports discussing these findings. However, when discovered, they most often affect the orbital vein.…”

“… 1 The facial vein and/or its branches can also be affected, and these will usually be thrombosed at the diagnosis. 2 , 3 , 4 The presentation can mimic acute and chronic pathologies of the head and neck region, including congenital varicosity, neoplasm of salivary glands or metastatic disease, cysts, abscess, and lymphatic or vascular malformations. Infection, trauma, or contiguous venous obstruction can precede facial varix formation.…”

“…In the few case reports of facial varix, the location, laterality, symptoms, and acuity all varied. 1 , 2 , 3 , 4 The “turkey-wattle sign,” originally described in the English language in 1988, occurs with fluctuation in the size of the mass with bending the head downward. 4 Diagnostic imaging studies, including ultrasound, computed tomography (CT), and/or magnetic resonance imaging (MRI), are important adjuncts for the correct diagnosis, especially because a standardized treatment regimen does not exist.…”