Intramuscular hemangiomas of the mylohyoid and sternocleidomastoid muscle

Intramuscular hemangiomas of the head and neck are uncommon benign vascular tumors. They arise frequently in the masseter and trapezius muscle. However, intramuscular hemangiomas arising from the mylohyoid and sternocleidomastoid muscle are extremely rare. We, herein, report additional two cases with intramuscular hemangioma of the mylohyoid and sternocleidomastoid muscle, and review the literatures pertaining to this condition. Imaging studies such as magnetic resonance image (MRI) were diagnostic and the tumors were resected completely with the cuff of normal surrounding muscle. At follow-up examination the patients have been well, without evidence of tumor recurrence after surgery. Intramuscular hemangioma of the head and neck, despite its rarity, should be considered in the differential diagnosis of the head and neck masses.     

Hemangioma of the masseter muscle.

Intramuscular hemangiomas are rare benign tumors of vascular origin. The masseter is the muscle most commonly involved in the head and neck. A case of intramuscular masseter hemangioma is presented, the literature reviewed, and appropriate diagnostic modalities discussed.     

Invasive intramuscular hemangiomas of the head and neck

Intramuscular hemangiomas make up less than 1% of all hemangiomas [1]. These invasive and aggressive lesions appear to have a predilection for large muscle masses. They can be strikingly aggressive in the head and neck, and persistence despite radical treatment is common. Spontaneous resolution in adults to our knowledge has not been reported in the literature. We present a case report of an invasive intramuscular hemangioma involving the parotid gland, the masseter and pterygoid muscles, and the infratemporal fossa after local resection of an apparently isolated lesion of the lip and the submandibular triangle. We describe a detailed course of treatment and review the literature.     

Intramuscular hemangioma of the head and neck

Intramuscular hemangiomas are unusual tumors in the head and neck region that occur most frequently in the masseter muscle and are often confused with parotid neoplasms. Four cases are described and the literature reviewed. The diagnosis and management of these tumors are discussed in view of the fact that accurate preoperative diagnosis is unusual and tumor recurrence rates high. Increased awareness of the clinical presentation of intramuscular hemangiomas should enhance diagnostic accuracy and facilitate optimal treatment planning.     

Intramuscular hemangioma of posterior neck muscles

Intramuscular hemangiomas of the head and neck are rare tumors, sparsely reported. They usually present themselves as a mass which enlarges suddenly. A case of intramuscular hemangioma involving the posterior neck muscles is presented. Computed tomography scanning, magnetic resonance imaging and angiography revealed the vascular nature of this lesion. Surgery consisted of a wide excision. The patient is free of disease after a 4-year follow-up. Received: 25 July 2000 / Accepted: 10 November 2000     

Rare intramuscular haemangioma of the sternocleidomastoid muscle

Intramuscular tumours of the head and neck often represent a differential diagnostic challenge. We report the rare case of an intramuscular haemangioma arising from the sternocleidomastoid muscle in the 6th decade. Pre-operative diagnosis was difficult, as these tumours are extremely uncommon in the head and neck region, with only very few cases reported in the literature. Due to the marked tendency of intramuscular hemangiomas to recur, accurate preoperative diagnosis forms the basis of adequate surgical therapy with sufficient safety margins.     

Seltenes intramuskul?res H?mangiom des M.?sternocleidomastoideus

Intramuscular tumours of the head and neck often represent a differential diagnostic challenge. We report the rare case of an intramuscular haemangioma arising from the sternocleidomastoid muscle in the 6^th decade. Pre-operative diagnosis was difficult, as these tumours are extremely uncommon in the head and neck region, with only very few cases reported in the literature. Due to the marked tendency of intramuscular hemangiomas to recur, accurate preoperative diagnosis forms the basis of adequate surgical therapy with sufficient safety margins.     

Intramuscular hemangioma of the masseter muscle

Intramuscular hemangiomas (IMH) are uncommon tumors of the head and neck, but often occur in the trunk and extremities. When present in the head, the masseter muscle is the most frequently involved site, although constituting only 0.8% of all hemangiomas. Accurate preoperative diagnosis is uncommon without cytology or biopsy. A case of IMH of the masseter muscle in a 24-year-old Turkish woman is presented. Clinical, radiologic and histologic findings and treatment modalities are reviewed. Received: 5 March 1998 / Accepted: 7 August 1998     

Rare case of intramasseteric cavernous hemangioma in a three-year-old boy: a diagnostic dilemma

Intramuscular hemangiomas are rare, benign tumors of vascular origin. The masseter is the muscle most commonly involved in the head and neck region. Because of their infrequency, deep location, and unfamiliar presentation, these lesions are seldom correctly diagnosed clinically. This case report presents a severe facial asymmetry caused by a left intramasseteric cavernous hemangioma in a 3-year-old boy. We were unaware of the exact nature of the tumor until intraoperative examination. The routine investigations performed before operation failed to establish a diagnosis. Surgical excision was performed, and 1 year after the operation we observed that the patient's facial asymmetry had been corrected. In this article, we review the literature on intramasseteric hemangioma, discuss the clinical and radiologic diagnostic methods, and review the treatment methods.     

Superselective embolization of laryngeal hemangioma

Diffuse upper respiratory hemangiomas are extremely rare lesions. Unlike the much more common congenital subglottic hemangiomas, diffuse upper respiratory hemangiomas do not resolve spontaneously and may prove quite recalcitrant to conventional forms of therapy. Superselective embolization, a highly successful technique for the management of head and neck vascular lesions, was used to effectively control an obstinate laryngotracheal hemangioma. Superselective embolization appears to provide yet another viable therapeutic option in the management of laryngeal hemangiomas.     

Jugular foramen capillary hemangioma masquerading as a paraganglioma

Capillary hemangiomas are benign vascular lesions that are common in head and neck, but hemangiomas of jugular foramen and temporal bone are rare with only a few cases reported in the literature. We present a case report of this rare disease entity highlighting the subtle radiographic nuances that can benefit clinicians when encountered with similar unusual clinical scenario. Although radiographic features of capillary hemangioma can be distinctive, they are not specific. In this case, the lack of significant involvement of the jugular bulb and the absence of the typical pattern of osseous erosion of the jugular carotid spine led to the alternative diagnosis of a rare capillary hemangioma of the jugular foramen.     

Nasopharyngeal hemangioma causing airway obstruction in infancy

The clinical presentation, diagnostic evaluation, and treatment of a 3-month-old infant with symptomatic airway obstruction caused by a nasopharyngeal hemangioma is discussed. The pathophysiology of nasopharyngeal airway obstruction in the infant and the clinical management of hemangiomas of the head and neck are reviewed.     

Subglottic hemangioma of the larynx treated with steroid therapy

Previous experience with different modes of therapy of subglottic hemangioma have not been entirely satisfactory. Response of hemangiomas in general and specifically subglottic hemangiomas in infants to steroid therapy prompted this mode of therapy in two infants. Because of the possible late complications of radiation therapy to the head and neck area of children, a safer modality might avoid these possible complications. One patient with a biopsy proven cavernous hemangioma was decannulated six months following prednisone therapy. The second case, with histologically proven capillary hemangioma, did not have as great an initial response to steroid therapy. External signs of a Cushingnoid syndrome developed in both cases and improved with no residual effects on tapering doses of medication.     

Cavernous hemangioma of the external ear canal

Cavernous hemangiomas are benign tumors of blood vessel origin. Cavernous hemangiomas arising from the tympanic membrane with or without involvement of the skin of the deep external auditory canal may occur in rare cases. In this paper, the clinical and pathological findings in the first recorded case of a patient with a cavernous hemangioma arising from the skin of the deep external canal with no involvement of the tympanic membrane are presented.     

Circular excision and purse-string suture technique in the management of facial hemangiomas

Hemangiomas are the most common soft tissue tumors in infancy. Treatment options for hemangiomas are numerous. The scar after lenticular excision and linear closure is often unacceptable. Localized cutaneous infantile hemangioma acts like a tissue expander. Therefore, circular excision and purse-string suture technique are applicable for hemangioma at any stage. For 2-year period we have operated 14 patients with hemangioma using circular excision and purse-string suture technique. In eight patients hemangioma was localized in the head and neck region. Two infants with large hemangioma of the face are presented in this article. One patient had hemangioma with ulceration resistant to conservative treatment. Second patient had giant hemangioma, which caused partial disturbation of visual axis. We applied circular excision and purse-string suture technique in both patients. The results were good, without any postoperative complications.     

Intramuscular haemangioma of head and neck region

Intramuscular haemangiomas are rare benign haemangiomas occurring within the skeletal muscle. These are uncommon tumours in the head and neck region and occur most frequently on the trunk and extremities. Fewer than 80 cases of intra-muscular haemangioma in the head and neck region have been reported in the literature. A case of intramuscular haemangioma of the sternocleidomastoid muscle is presented. The review of occurrence and natural history of such tumours is described and clinical and radiological presentation, histological classifications and treatment modalities are discussed.     

Postcricoid hemangioma of childhood: report of four cases

Hemangiomas are the most common tumor of infancy, and the vast majority occur in the head and neck region. In children, laryngeal hemangiomas typically occur below the level of the true vocal folds, in the region of the subglottis, and other sites are exceedingly rare. We present four cases of hemangiomas located in the postcricoid region of the hypopharynx. Because of the location of these lesions, children may present with obstructive symptoms such as dysphagia, intermittent aspiration, hypersalivation, or recurrent respiratory infections. Clinical diagnosis is relatively easily made with flexible laryngoscopy, as the lesions have a propensity to enlarge with crying or straining. When these patients are examined under general anesthesia in a relaxed state, however, the lesions are typically much smaller, and can even go unnoticed. Unlike other reported cases, the postcricoid hemangiomas in our patients were not causing any symptoms and were simply incidental findings. Thus, we believe that the true incidence of postcricoid hemangiomas is likely higher than reports suggest. To our knowledge, we report the longest follow-up (6 years) of a patient with a postcricoid hemangioma and are the first to describe the natural course of such a lesion.     

Treatment of nasal hemangiomas

Hemangiomas are the most common soft tissue tumors of infancy. Almost 60% of these tumors develop in the head and neck region. Nasal hemangiomas, distort human physiognomy and leave long lasting psychological sequelae. Conservative approach (intralesional corticosteroids, laser) may accelerate involution. Proponents of an early surgery suggest that aesthetic improvement during a critical period in child development can be achieved. Fourteen patients with nasal hemangioma were treated during 5-year period (2003-2007) with intralesional corticosteroids, lenticular excision, open rhinoplasty excision, and circular excision with “purse string suture”. The first line of treatment for large nasal hemangiomas is intralesional corticosteroids. Excision is indicated for small hemangiomas, while subtotal excision is preferable for large nasal hemangiomas. Circular excision and “purse string suture” is appropriate for prominent hemangiomas with predominant deep component. In our opinion surgery with maximal care for nasal architecture is the treatment option for nasal hemangioma.     

Congenital head and neck masses in infants and children. Part II

Congenital head and neck masses in children are a diverse group of lesions. Thyroglossal duct abnormalities are the most common, followed by branchial apparatus abnormalities, lymphangiomas (cystic hygroma), and subcutaneous vascular abnormalities (hemangioma, AVM). It is important to note that cutaneous hemangiomas are not included in this discussion of congenital masses. If they are considered within the general topic of congenital head and neck masses, vascular lesions by far are the most common. Teratomas and dermoid cysts represent true congenital neoplasms and are relatively uncommon. Several rare lesions have been noted in the discussion and should be included in the differential diagnosis. The diagnosis of these particular masses depends largely on history and physical examination. The location of the mass itself greatly limits the differential diagnosis. Ancillary studies such as plain x-rays, ultrasound, CT scanning, and angiography are useful in further limiting the possible diagnoses. Subcutaneous hemangiomas, ectopic thyroid, congenital goiter, and fibromatosis colli can be treated medically or with simple observation. Surgery is reversed for enlarging lesions or lesions affecting vital structures. The remainder of the congenital head and neck masses generally require early excisions to avoid complications of infection, airway obstruction, nutritional compromise, or the risk of malignant transformation.     

Dynamic computerized tomography in the assessment of hemangioma

Three hemangiomas of the face and orbit are studied with dynamic computerized tomography (CT). This noninvasive technique has the advantage of simultaneous bone and soft tissue visualization at the time of peak contrast enhancement, and it precludes the potential complications of arteriography and biopsy. The hemangiomas are precisely delineated with intense contrast; the sharp peak and rapid uninterrupted runoff of the computer-generated plot of contrast concentration (CT number) versus time is characteristic of this lesion. It is suggested that the progress of hemangioma involution may be documented by the change in contrast distribution in sequential dynamic CT studies. Dynamic CT is recommended for the evaluation of head and neck vascular tumors.