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ORIGINAL ARTICLE Table of Contents   
Year : 2003  |  Volume : 13  |  Issue : 1  |  Page : 15-16
Congenital hemangioma of parotid gland : A case report


Smt. NHL Municipal College, Seth VS Hospital, Ahmedabad, India

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Keywords: Hemangioma, Parotid Gland

How to cite this article:
Bhatt C J, Jagrit N N. Congenital hemangioma of parotid gland : A case report. Indian J Radiol Imaging 2003;13:15-6

How to cite this URL:
Bhatt C J, Jagrit N N. Congenital hemangioma of parotid gland : A case report. Indian J Radiol Imaging [serial online] 2003 [cited 2014 Jul 30];13:15-6. Available from: http://www.ijri.org/text.asp?2003/13/1/15/28616
Hemangioma of the parotid gland represents about 1-5% of all salivary gland tumors. Hemangiomas are commonest neoplasms in childhood but capillary hemangiomas are rare in parotid glands. [1]. we present a case of congenital capillary hemangioma of the parotid gland.


   Case report Top


A three-month old baby presented with a swelling in the left parotid gland region since birth. Three were no other complaints.

On examination there was a diffuse swelling in the left parotid region since birth. The overlying skin was normal. On palpation the swelling was soft. The clinician suspected it to be either a hemangioma or a lymphangioma. The patient was refered for an ultrasound examination.

USG revealed the parotid gland to be enlarged and diffusely hypo echoic. [Figure - 1]. There were multiple small anechoic areas within. There was a large anechoic channel within the gland [Figure - 2]. On colour Doppler study the anechoic channel and other anechoic areas were filled up with colour indicating the vascular nature of this lesion [Figure - 3]. This was reported as a hemangioma. The tumor was excised and sent for biopsy. Biopsy showed a single line of endothelial cells with multiple blood vessels present in between the glandular tissue. These were interconnected at places. Plenty of RBCs were seen. There was no evidence of mitotic activity in the cells. This ruled out a malignant nature of the lesion and the diagnosis of hemangioma was confirmed.


   Discussion Top


Non-epithelial tumors overall constitute less than 5% of all salivary gland neoplasms, but in children they represent more than 50% of all tumors. These include lymphangiomas, hemangioma, lymphoid lesions, neurogenic tumors, lipomas and sarcomas. [2]

Capillary hemangiomas are rare in the parotid gland. Submandibular gland involvement is also rare. However in this case it may be difficult to distinguish between tumors arising within the gland or those arising within the soft tissue adjacent to the gland.

Hemangiomas are classified into capillary and cavernous type. The congenital capillary type of hemangioma is the predominant subtype in the first year of life. They represent about 90% of these lesions [3]. Cavernous hemangiomas are seen in older children. Capillary hemangiomas, discovered shortly after birth, are unilateral and compressible. Rapid enlargement can occur and bluish discolouration of the skin can be seen. These non-capsulated lobulated lesions are more common in girls. [1]. However our patient was a male child.

The normal parotid glands can be easily visualized on USG as homogenous echogenic structures [4]. On USG the echogenicity of a hemangioma is variable and depends on the size of the cystic component. The gland is usually enlarged and appears hypoechoiec or more or less isoechoiec, but may be echogenic compared to the surrounding cervical soft tissues. They are highly compressible. Color doppler study helps to detect the perfusion in the hemangioma and confirm the vascular nature of the lesion and helps to differentiate it from a lymphangioma [5].

On ct these tumors enhance they are often lobular, may extend to the overlying skin or may have phleboliths. The mass effect of the tumor on the surrounding tissues is relatively rare reflecting their soft nature. On MRI T1W images demonstrate low to intermediate inhomogenous signals with increased signal intensity on T2W. Flow voids may be present and areas of increased signal intensity on T1W and T2W sequences may represent prior hemorrhage or slow flow. CT and MR imaging may help in differentiating other possibilities like lymphangiomas or malignant hemangioendothelioma. No known malignant transformation of this lesion occurs. [3]. Typically these capillary hemangiomas of early childhood regress by adulthood.

 
   References Top

1.Peter Som, Hugh D Cortin. Head and neck imaging. 3rd edition vol.2. St Louis: mosby, 1996: 90-902.  Back to cited text no. 1    
2.Peel RZ, Gnepp D R diseases of salivary glands. In: Barners 2 (Ed). Surgical pathology of head and neck. Vol 1. New York: Marcel Dekkerr, 1985: 535-552.  Back to cited text no. 2    
3.Touloukia R J salivary gland diseases in infants and children. In: Rankow R M, Polayes LM (Eds). Diseases if salivary glands. Philadelphia: W B Saunders, 1976: 284-303.  Back to cited text no. 3    
4.Gritzmann N. High resolution sonography of salivary glands. AJR 1989; 161-166.  Back to cited text no. 4    
5.James D Rabinor; Radiologic evaluation of the neck. RCNA 2000; 38:5:1035.  Back to cited text no. 5    

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Correspondence Address:
C J Bhatt
A/28 Ashok Tenements, Opposite Cadila, Ghodasar, Ahmedabad
India
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[Figure - 1], [Figure - 2], [Figure - 3]



 

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