MyPACS.net: Radiology Teaching Files > Case 325119

never visited PAROTID HEMANGIOMA
Contributed by: Faculty and residents Children's Hospital, Radiologist, Children's Health System, Birmingham, Alabama., USA.
Patient: 1 year old male
History: One year old patient with history of a right facial mass which is soft and pliable. The mass has a bluish color particularly when he cries.
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Findings: Pre and post contrast MRI of the face reveals large heterogeneous mass involving the right parotid gland in the superficial and deep parotid space. This lesion has increased signal on T2 and is iso to muscle on T1. Brisk enhancement is noted with contrast administration and multiple flow voids are noted.
Diagnosis: Hemangioma
Discussion: Differential considerations include congenital( branchial cleft cyst, hemangioma, lymphangioma), infectious(abcess, cellulitis, lymphoepithelial lesion, reacive adenopathy), neoplasm(pleomorphic adenoma). The imaging characteristics and flow voids along with the patients age is consistent with a paritod hemangioma. The clinical presentation includes parotid swelling shortly after birth. The mass is compressible and soft with a bluish discoloration when crying. CT will show marked enhancement. Of note this lesion invloves the entire parotid gland, therefore the VII nerve runs through this lesion. Treatment includes watchful waiting and to postpone surgery as long as possible because many will involute and there is a possibility of facial nerve trauma.
References:

Pediatric Radiology, The Requisites. Second Edition.Hans Blickman, M.D., et al.1198 Mosby, Inc.

Handbook of Head and Neck Imaging, Second Edition. H.Ric Harnsberger, M.D., et al 1995 Mosby, Inc.

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Additional Details:

Case Number: 325119Last Updated: 03-16-2004
Anatomy: Face and Neck   Pathology: Neoplasm
Modality: MRExam Date: Access Level: Readable by all users

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