Intramuscular Hemangioma of the Masseter Muscle Mimicking Parotid Sialolithiasis

Abstract

Intramuscular hemangioma occurs in less than 1% of soft tissue hemangiomas. It is equally prevalent in men and women. In this study, we examined a case of a masseter muscle hemangioma with evidence of a suspected parotid sialolithiasis. A 24-year-old woman with a 3-year history of swelling and mild pain in the cheek and ear area was referred to our Department. Before the sialography, ultrasound imaging (sonography) was performed as an initial examination. Due to the calcification in the anterior region of the masseter muscle observed in earlier CT images, sialography was scheduled for the differential diagnosis of sialolithiasis. Sonograms showed a complex tubular mass of 20 × 35 mm in the anterior region of the masseter muscle. The mass appeared hyper vascular on color Doppler ultrasound, confirming its vascular nature. Due to its proximity to the facial nerve, a diode laser was adopted for treatment. Since intramuscular hemangiomas do not regress spontaneously and can be mistakenly diagnosed as parotid gland tumors or sialolithiasis, correct diagnosis is essential. Sonography can help with this.