Hemangioma parotid gland in an adult an interesting case report

Case details:


1. Swelling over right angle of jaw - 3 years - Gradual increase in size

2. No history of pain

On examination:

Soft globular swelling measuring 4 x 3 cms seen occupying the right angle of mandible. It was warm and compressible.
The skin over the swelling was free.
The swelling could be moved over underlying tissues.
Transillumination negative


Clinical photograph of the patient


Axial CT of the area showed radiolucent hypodense globular mass attached to the lower pole of the parotid gland.
Contrast CT showed contrast enhancement of the mass.


Picture showing the CT image


The tap turned out to be bloody in nature.


The patient was taken up for surgery under general anesthesia. The mass was removed in toto.




Mass being exposed


Mass seen being removed


Mass after removal

Histopathology report:

Consistent with cavernous hemangioma of parotid gland


Hemangioma of parotid gland is a rather common lesion in infants and children. It is rather rare in adults.
Histologically this mass is composed of solid masses of cells with capillary vascular spaces. Normal salivary
gland tissues are usually replaced by the mass. These masses are usually soft, warm and compressible and
donot transilluminate. A period of wait and watch is usually followed. Indications for surgical intervention
include rapid increase in size, and pain.
There is still a raging controversy whether hemagioma could be a true tumor involving blood vessels or a vascular
malformation (Hamartoma).
These masses usually become prominent when the head is bent forward or when the patient lies horizontally (This is
classically known as Turkey wattle sign). Rarely multiple phleboliths can be seen within the mass.
Peel & Gnepp classified hemangioma of salivary glands as follows:
1. Benign hemangioendothelioma
2. Cavernous hemangioma
3. True capillary hemangioma (rare)
There is absolutely no role for scerotherapy in these patients.

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