Abstract
Facial swelling is commonly encountered in paediatric patients and is typically related to an underlying infection. The spectrum of possible causes, however, is wide, and includes traumatic, inflammatory, nutritional and neoplastic aetiologies. In this pictorial essay we present 13 examples of rare conditions selected from a total of 136 MRI examinations performed at our institution between April 2007 and May 2013. These include HIV-associated malignancies such as a case of plasmablastic lymphoma, parotid gland tumours including a parotid hamartoma, rare congenital lesions such as a thyroid fetiform teratoma, and infective lesions including tuberculosis of the mandible. In many cases, only minimal information could be gleaned from the literature, particularly with regard to imaging findings. An analysis of the spectrum of masses and specific clinical presentations allowed for the construction of a diagnostic flowchart which may serve to assist in unusual cases.Teaching Points• Facial swelling is commonly encountered in paediatrics, with a wide spectrum of possible aetiologies.• MRI is the favoured imaging modality for accurate assessment.• Facial swelling is typically infectious in nature, but includes various benign and malignant causes.• This pictorial essay presents 13 examples of rare conditions with corresponding imaging.
Highlights
Facial swelling is a common clinical scenario in the paediatric setting, associated with a diverse range of possible causes
The underlying aetiology ranges from congenital lesions to infective and inflammatory conditions, and various other benign or malignant masses [1]
Advances in imaging techniques have led to the everincreasing use of computed tomography (CT) and magnetic resonance imaging (MRI) for evaluating the extent of disease and for treatment planning [1]
Summary
Facial swelling is a common clinical scenario in the paediatric setting, associated with a diverse range of possible causes. The underlying aetiology ranges from congenital lesions to infective and inflammatory conditions, and various other benign or malignant masses [1]. Our series includes 13 examples of rare, biopsyproven conditions (Table 1), selected from a total of 136 MRIs of children presenting with facial masses between April 2007 and May 2013. These include two HIV-associated malignancies, three parotid gland tumours, two congenital facial masses, two lesions of the mandible, a paranasal sinus tumour, and three additional unusual facial malignancies. Lesions present for 3 months or less were predominantly malignant tumours, and included congenital and infectious causes. The congenital lesions comprised both benign and malignant aetiologies and exhibited variable imaging characteristics
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