PMC9761797_01
Photographs of infant demonstrating shrinkage of mass over time.
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A 37-week gestation 2.37-kg female born to a 35-year-old G2P2 mother via spontaneous vaginal delivery was found to have a left-sided facial mass that extended from the inferior orbit to the left auricle and past the mandible into the superior neck (Figure 1).
Gray scale and color doppler transverse ultrasound images of the left facial
mass demonstrate a solid mass with increased blood flow.
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Ultrasound of the affected area on DOL 2 revealed a large mixed solid and cystic mass in the left cheek and neck that abutted the airway and adjacent vessels (Figure 2).
Coronal and axial T2W MR images demonstrate a hypertense solid mass centered
in the left masticator, parapharyngeal and parotid spaces. There is superior
extension into the left middle cranial fossa, cavernous sinus, temporal
bone, occipital bone, and posterior fossa; inferior extension into the
submandibular space; medial extension into the nasopharynx and oropharynx
resulting in severe airway narrowing; posterior extension into the left
posterior triangle of the neck. Large internal flow voids representing
vessels are noted in the mass resulting in high vascularity as seen on
ultrasound.
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Magnetic resonance imaging (MRI), performed on DOL 3, demonstrated a large vascular craniofacial soft tissue mass measuring 5.8 x 5.5 x 6.1 cm3 (craniocaudal, AP, transverse) centered in the left parapharyngeal, masticator, and parotid spaces with superior extension into the left cavernous sinus, left temporal bone, left occipital bone, extradural left middle and posterior cranial fossa, medial extension into the retropharyngeal space, posterior extension into the left cervical posterior triangle, and inferior extension into the left submandibular space (Figure 3).
Trend of platelet count and fibrinogen concentration.
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Thrombocytopenia, anemia, hypofibrinogenemia, and elevated d-dimer improved over the first 2 weeks of life (Table 1 and Figure 4).