PMC4065433_01
Swelling on right dorsal surface of tongue extending to ventral surface with bluish color
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F1
An 18-year-old male patient had history of multiple abnormal nonspecific swellings on the tongue [Figure 1], right cheek [Figure 2], left lateral neck, preauricular area [Figure 3], left parietal region of skull [Figure 4], right submandibular region and lower part of right masseter region [Figure 5] and on both the sides of shoulder [Figure 6].
Prominent soft swelling on right cheek area
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F2
An 18-year-old male patient had history of multiple abnormal nonspecific swellings on the tongue [Figure 1], right cheek [Figure 2], left lateral neck, preauricular area [Figure 3], left parietal region of skull [Figure 4], right submandibular region and lower part of right masseter region [Figure 5] and on both the sides of shoulder [Figure 6].
Swelling on thee left preauricular area and left lateral neck region
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F3
An 18-year-old male patient had history of multiple abnormal nonspecific swellings on the tongue [Figure 1], right cheek [Figure 2], left lateral neck, preauricular area [Figure 3], left parietal region of skull [Figure 4], right submandibular region and lower part of right masseter region [Figure 5] and on both the sides of shoulder [Figure 6].
Swelling seen on left/parietal region of skull
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F4
An 18-year-old male patient had history of multiple abnormal nonspecific swellings on the tongue [Figure 1], right cheek [Figure 2], left lateral neck, preauricular area [Figure 3], left parietal region of skull [Figure 4], right submandibular region and lower part of right masseter region [Figure 5] and on both the sides of shoulder [Figure 6].
Swelling in the right submandibular region and lower part of right masseter region
JOMFP-18-137-g005.jpg
PMC4065433_01_JOMFP-18-137-g005.jpg
F5
An 18-year-old male patient had history of multiple abnormal nonspecific swellings on the tongue [Figure 1], right cheek [Figure 2], left lateral neck, preauricular area [Figure 3], left parietal region of skull [Figure 4], right submandibular region and lower part of right masseter region [Figure 5] and on both the sides of shoulder [Figure 6].
Prominent bilateral swellings in the posterior shoulder girdle region
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F6
An 18-year-old male patient had history of multiple abnormal nonspecific swellings on the tongue [Figure 1], right cheek [Figure 2], left lateral neck, preauricular area [Figure 3], left parietal region of skull [Figure 4], right submandibular region and lower part of right masseter region [Figure 5] and on both the sides of shoulder [Figure 6].
Magnetic resonance imaging showing swellings at right side base of neck is semispinalis capitus muscle measuring 39 x 35 mm at C2 and C3 level and midline posterior subcutaneous locations measuring 50 x 34 mm from C2 to C4 level and extends downwards to left side subcutaneously
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F7
A multiplanar and multisequence MRI neck plain and contrast findings showed multiple well-defined lobulated, variably sized, T2 hyperintense and T1 hypointense lesions with multiple flow voids and striated appearance both subcutaneously and in the inter/intra muscular regions [Figures 7 and 8].
Magnetic resonance imaging of left side of cheek in subcutaneous plane lateral to masseter muscle measuring 43 x 26 mm and right anterior surface of cheek lateral to superior alveolar margin in subcutaneous plane measures 44 x 33 mm and deep extends between masseter and medial pterygoid muscle and infratemporal fossa involving tongue
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F8
A multiplanar and multisequence MRI neck plain and contrast findings showed multiple well-defined lobulated, variably sized, T2 hyperintense and T1 hypointense lesions with multiple flow voids and striated appearance both subcutaneously and in the inter/intra muscular regions [Figures 7 and 8].
Skull anteroposterior/lateral view showed calcification foci noted within soft tissue opacities
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F9
Calcification foci were noted within soft tissue opacities [Figure 9].
(a) Histopathology showed dilated vascular channels (H&E stain, x40). (b) Histopathology showing fatty overgrowth and fatty replacement and associated nerve bundles (H&E stain, x40). (c) Histopathology showing nerve bundles (H&E stain, x40)
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F10
Histopathological examination showed progressively enlarging, dilated vascular channels lined by flattened, endothelium [Figure 10a]. There was fatty overgrowth that may be due to skeletal muscle atrophy with fatty replacement, bundles of nerve fibers and some of the veins with collapsed and narrow lumen were observed [Figure 10b and c].