PMC4983636_01
Pre Operative.
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Oral and Maxillofacial Surgery complaining of a swelling in the left cheek region since 3 years. On clinical examination a smooth, oval swelling of size 2 x 3 cm diameter was noted in the left cheek region (Fig. 1).
Pre Operative scan (MRI scan).
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Radiographic investigation including MRI scan and Angiogram was done and it revealed an enhancing well circumscribed intramuscular mass (Fig. 2).
Incision and Flap elevation.
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Submandibular incision was placed (Fig. 3).
Lesion exposed 1.
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Skin flap were raised and lower border dissection was done through masseter muscle to expose the well encapsulated lesion (Fig. 4).
Lesion exposed 2.
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Once lesion is exposed a blunt dissection was done around the lesion and cauterization was done for any bleeding vessels (Fig. 5).
Excised Lesion (see the glistening capsule).
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On the specimen a glistening capsule was seen covering the whole vascular tumour (Fig. 6).
Surgical defect and Closure.
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The whole exposed specimen was send for histopathology (Fig. 7).
Microscopic appearance.
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The intervening connective tissue stroma is densely collagenous comprising of dense collagen fibres with spindle fibroblast, fat cells and muscle tissue (Fig. 8).
One-year post op.
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Focal hemosiderin pigmentation is noted (Fig. 9).