4-months infant with enlarging soft mass at face

 

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Doctor's Information

Name : Maryam
Family :Noori
Affiliation : Teb Azma Imaging Center,Ghom,Iran
Academic Degree: Radiologist
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident : ----------------

 

Patient's Information

Gender : Female
Age : 4

 

Case Section

Head & Neck Imaging

 

Clinical Summary

4-months infant with enlarging soft mass at face.

 

 

Imaging Procedures and Findings

A 4-months-old girl with enlarging soft mass at right side of face& tongue underwent spiral CT scan with contrast. Performed images show a diffusely enhancing lobulated mass of the right parotid space extending to parapharyngeal space (PPS) also you can see reactive lymphadenopathies at high jugular chain.

 

Discussion

Hemangioma is a benign tumor of endothelial cells origin. It has two stage process of growth (proliferation) and regression, small or absent at birth with rapid growth over first several months of life & involution over months to years. It is most common tumor of childhood (12% of infants). 60% present at head and neck, 25% involve trunk & 15% extremities. General imaging features are: Discrete, well-defined, lobulated mass with diffuse enhancement & homogeneous in appearance. High flow vessels both within and adjacent to mass could be seen. On involutional phase, they decrease in size and cause fatty replacement. Congenital capillary hemangioma is the most common cause of parotid swelling in the newborn. Capillary type hemangiomas are the most common (90%) parotid gland neoplasm of infants, occurring most commonly in females, and are the most common cause of parotid swelling in the newborn. They can occur in the submandibular gland. Spontaneous involution occurs in 50% of capillary hemangiomas, particularly during the second and third years of life. An overlying cutaneous angioma may be present. Cavernous hemangiomas are seen in a slightly older age group; these may contain phleboliths and are less apt to regress. Hemangiomas may be well circumscribed or infiltrative and can involve the adjacent musculature. Cavernous hemangiomas may be identified in salivary glands and are noted as being seen in older children and adults, as primarily involving the parotid gland and as being characterized by the presence of dilated, thin-walled vessels lined with flattened endothelial cells. Unlike capillary hemangioma the cavernous hemangioma does not regress and therefore requires complete surgical excision.

 

Final Diagnosis

Infantile Hemangioma.

 

References

Diagnostic Imaging Head & Neck, Harnsberger, et al. Valvassori??s imaging of the head & neck. MF. Mafee et al.

 

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