Kishimoto Tsukasa, Sukegawa Shintaro, Katase Naoki, Kanno Takahiro, Sukegawa-Takahashi Yuka, Masui Masanori, Sato Ai, Furuki Yoshihiko
Division of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital, Kagawa.
Department of Oral Pathology and Bone Metabolism, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki.
J Craniofac Surg. 2019 Jan;30(1):193-195. doi: 10.1097/SCS.0000000000004933.
Hemangiomas are benign vascular soft tissue tumors, which most frequently occur in the skin or subcutaneous tissue. Intramuscular hemangiomas typically occur in the trunk and extremities and less frequently in the head and neck. Among these, those occurring in the temporalis muscle are extremely rare. The authors report the case of a 43-year-old Japanese male with a mass in his left temporal fossa. Computed tomography images showed no erosion of the zygomatic bone, and magnetic resonance imaging revealed an ovoid well-marginated mass within the temporal muscle. The lesion was surgically excised with an endoscopy procedure used for minimally invasive lesions and complete removal. Histopathological examination confirmed the diagnosis of intramuscular cavernous hemangioma. The postoperative clinical course was good, with no indications of temporary nerve paralysis. No signs of local recurrence were observed postoperatively. Therefore, a cavernous hemangioma should be suspected when a mass occurs in the temporal region with accompanying radiologic findings suggesting vascular origin. In surgical treatment, the endoscopy-assisted technique is very useful to achieve complete tumor resection and prevent relapse while avoiding serious complications due to surgical procedures.
血管瘤是良性血管软组织肿瘤，最常发生于皮肤或皮下组织。肌内血管瘤通常发生于躯干和四肢，较少发生于头颈部。其中，发生于颞肌的极为罕见。作者报告了一例43岁日本男性，其左颞窝有一肿块。计算机断层扫描图像显示颧骨无侵蚀，磁共振成像显示颞肌内有一个边界清晰的椭圆形肿块。采用用于微创病变的内镜手术将病变切除并完全清除。组织病理学检查确诊为肌内海绵状血管瘤。术后临床过程良好，无暂时性神经麻痹迹象。术后未观察到局部复发迹象。因此，当颞区出现肿块并伴有提示血管起源的影像学表现时，应怀疑为海绵状血管瘤。在手术治疗中，内镜辅助技术对于实现肿瘤完全切除、防止复发以及避免手术操作引起的严重并发症非常有用。
