Paediatric Masseter Hemangioma with Facial Nerve Involvement: A Diagnostic and Therapeutic Challenge.

Abstract

Intramuscular haemangioma of the masseter muscle is an infrequent entity which is often misdiagnosed because of lack of symptoms. The rarity, asymptomatic indolent character and deep seated location makes these swelling a diagnostic dilemma and therapeutic challenge. This case report is an appraisal of the diagnosis and management of intramuscular masseteric haemangioma from an otolaryngological perspective and is being reported here for its rarity, inherent surgical challenge and academic interest. We report a case of intramuscular haemangioma of right side masseter muscle in a 10-year-old boy. The atypical indolent asymptomatic slow growth pattern and gradual involvement of facial nerve in this case warrants the necessity of reporting this case. We performed surgical excision of intra masseteric hemangioma with preservation of involved peripheral facial nerve branches. The peculiarity of the case gives insight into different types of presentation of pediatric haemangioma. The involvement of peripheral facial nerve branches in the swelling highlights the surgical dexterity involved in complete removal of head and neck haemangioma. It is important to identify such cases with thorough check up and high degree of suspicion by a clinician while dealing with such presentation. The treatment modality adopted should be based on individual clinical status of the patient.