Intramural Perimasseteric Hemangiomas of the Inner Cheek

Intramuscular hemangioma in the zygomaticus minor muscle: a case report and literature review

“…In rare cases, facial pain or headache may occur because of compression by the enlarging mass [ 5 ]. However, since IMH has no characteristic clinical symptoms, it is often misdiagnosed [ 6 ] and inappropriate surgical interventions are performed [ 7 ]. The differential diagnosis for masses of the zygomatic area includes lipoma, schwannoma, neurofibroma, and dermoid cyst [ 3 , 6 ].…”

“…US is a good option for preoperative diagnosis, but the vascularity of IMH is often not evident on US [ 8 ]. US-guided FNAB does not play a decisive role in the diagnosis, as it only obtains bloody specimens due to the bleeding tendency of these lesions [ 7 ]. Salzman et al [ 8 ] introduced a US-guided core needle biopsy (CNB) protocol that was successfully performed for the preoperative diagnosis of IMHs, however; due to bleeding risk, it is controversial whether FNAB or CNB should be done for accurate diagnosis [ 8 ].…”

Intramuscular hemangiomas on the masseter muscle and orbicularis oris muscle: a report of two cases

“…Over 90% of all IMHs are misdiagnosed15. Differential diagnosis of IMH includes lymphangioma, lymphomas, rhabdomyosarcoma, and schwannomas9. In particular, IMH arising from the masseter muscle is frequently confused with parotid tumor715.…”

“…However, angiography may be helpful when the feeding artery is large. Fine needle aspiration is not recommended due to the risk of hemorrhage9.…”

“…Several non-surgical treatments including cryotherapy, sclerosant injection, and arterial ligature have been described, but complete surgical resection is the curative intervention78. In the case of a large feeding vessel, embolization of the feeding vessels is recommended to reduce the risk of perioperative and postoperative bleeding9.…”