PMC3350060_01
Preoperative view of the patient.
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fig1
Trismus or facial palsy was not observed (Figure 1).
Preoperative MRI on T2-weighted image showing high signal intensity admixed with irregular low signal areas in left temporal fossa.
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fig2
Magnetic resonance imaging (MRI) revealed a relatively well-demarcated mass in the left temporal muscle, which showed low signal intensity on T1-weighted images and high signal intensity admixed with irregular low signal areas on T2-weighted images (Figure 2).
Preoperative contrast CT showing ill-demarcated low-density mass with enhancement of the adjacent temporal muscle.
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fig3
Heterogeneous enhancement of the mass and adjacent temporal muscle was observed between the coronoid process and temporal fossa (Figure 3).
Intraoperative view demonstrating intramuscular tumor (arrows) with the assistance of zygomatic osteotomy (asterisks).
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fig4
A solid nodule was palpated in the temporal muscle and continued beneath the zygomatic arch (Figure 4).
Microscopic findings of the spindle cell hemangioendothelioma. (a) Low-power view of the lesion showing cavernous blood vessels filled partly or completely with erythrocytes or thrombus admixed with cellular zones (hematoxylin-eosin, original magnification x40). (b) High-power view of juxtaposition of the cavernous and cellular areas illustrating blood-filled dilated vessels lined by flattened endothelial cells and spindle-shaped cellular components. There is no evidence of abnormal mitotic activity or nuclear atypia in spindled cells (hematoxylin-eosin, original magnification x100).
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fig5
Abnormal mitotic figures or cellular atypia was not observed (Figures 5(a) and 5(b)).
Postoperative view at 24 months followup.
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The patient was satisfied with the aesthetic result, though a mild depression was observed in the temporal area (Figure 6).