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Computed tomography identified a tumor at the superficial layer of the right masseter muscle with whirl enhancement (white arrow head). (A) Axial and (B) coronal view.
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Computed tomography (CT) of the neck showed a highly-vascularized, heterogeneous mass, 3 cm in diameter, in the superficial layer of the masseter muscle, with intratumor whirl-like contrast enhancement (Fig. 1).
Gross tumor specimen removed via en bloc resection.
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The tumor at the superficial layer of the masseter muscle was removed en bloc (Fig. 2).
Pathological examination revealed a cavernous-type hemangioma. Venous-type vessels with a large lumen and thin wall infiltrated with striated muscle bundles were identified. In addition, thrombus organization in the lumen was observed. (A) Vascular spaces (blue arrow) filled with organizing thrombi (black arrow) (stain, hematoxylin and eosin; magnification, x40). (B) Cystically dilated vascular spaces extending between individual skeletal muscle fibers (thin black arrow) (stain, hematoxylin and eosin; magnification, x400).
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Based on pathological examination of the excised specimen, a diagnosis of cavernous IMH was determined (Fig. 3).
Magnetic resonance imaging examination performed 1 year following surgery identified no recurrence of the tumor, as marked by a capsule of cod liver oil (arrow).
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The functional and cosmetic results were excellent, and no recurrence was identified on the 1 year magnetic resonance imaging (MRI) follow-up scans (Fig. 4).