Vascular malformations of the parotid region

Abstract

Five adult patients with vascular malformations in the parotid region are described. Three of these patients had lumps in the parotid gland clinically indistinguishable from parotid tumours: one had a diffuse swelling of the check, and the fifth had a pulsatile tumour in the deep lobe of the gland. Two patients had a characteristic sign-the lump in the cheek became more obvious, both visually and on palpation, when the masseter muscle was tensed. In 3 of the patients calcified opacities, resembling phleboliths, were demonstrated on plain X-ray examination. This is only the third report of vascular malformations of the parotid region in the British literature; no other report of a pulsating tumour within the parotid gland has been found in a search of the world literature.

Arteriovenous Malformation of the Parotid Gland: Case Report and Review of the Literature

“…This latter rarely regresses in size and may increase to impinge on vital structures. There is no evidence that these lesions are present at birth, raising the possibility of a developmental etiology rather than a congenital one, especially in the presence of a history of trauma to the region [5,6]. Most of the adult lesions are cavernous in nature, in contrast to the capillary form encountered in children [7].…”

“…The history is usually that of a solitary lump in the parotid region or diffuse swelling of the cheek. This parotid mass may fluctuate in size with a report of a history of swelling or pain that has resolved with antibiotics [6,7]. Trismus and facial paralysis have also been reported but to a lesser extent [9,10].…”

Cavernous Hemangioma of the Parotid Gland

“…11,37 Sialogram may demonstrate the mass as being separate from and displacing the duct system. 12,28,30 The classical calcification was present in Case 1 and was evident on the plain x-ray. CT scan was used in two of our patients and was useful in delineating the extent of the tumor.…”

“…9,11 The tumor may become visible and more easily palpable by tensing the masseter muscle when asking the patient to clench his teeth. 12 Rarely, the tumor may present as a pulsatile swelling within the parotid region 12 or with facial nerve palsy. 27 The lump may become more prominent when the head is bent forward or the patient lies horizontally 11 (turkey wattle sign).…”

“…[7][8][9] There is a controversy over whether or not hemangioma is a true benign tumor of blood vessels 10 or a vascular malformation, i.e., a hamartoma. [11][12][13] Caldwell and Campbell [14][15] reported the first parotid hemangioma in the British literature while Faber et al 12 reported the third series of adult parotid hemangioma in the British literature in 1978 after Gascoyen, 16 Dempsey and Murley. 11 Nomenclature of the tumor varies from author to author; Peel and Gnepp 17 present the most widely accepted classification as follows: 1.…”