Intramuscular Hemangioma of the Masseter Muscle with Phlebolith Formation-Case Report

位於咬肌的肌肉內血管瘤併靜脈石形成－個案報告

陳思翰(Szu-Han Chen) ； 謝式洲(Shyh-Jou Shieh)

《臺灣整形外科醫學會雜誌》 23卷2期 (2014/06) Pp. 182-188

摘要

背景：位於咬肌肌肉內血管瘤由於罕見加上大部份都沒有很特殊的臨床症狀而困難診斷，只有少部份的肌肉內血管瘤特別會有靜脈石或是鈣化的現象。目的及目標：我們提出一個案例來分享其診斷和治療的過程。材料及方法：這位51歲男性患者經由理學檢查以及核磁共振照影診斷出左咬肌內有肌肉內血管瘤並且有靜脈石的形成。我們在手術中經下頷下的傷口把左咬肌內的腫瘤以及含其中的靜脈石完整摘除。結果：由我們的案例中，我們切除咬肌肌肉的血管瘤並保留了顏面神經的分支以及顏面動脈，病人術後並沒有顏面神經麻痺和咀嚼無力的情形發生，對於外觀也令人滿意。結論：經由術前好的病史詢問、理學檢查和核磁共振照影下，我們可以在儘可能不傷害顏面神經與顏面動脈的情況下以下頷下的切開，順利的切除肌肉內血管瘤，不但可保留病患重要的顏面神經的功能且兼顧疤痕美觀的考量。

並列摘要

Background: Intramuscular hemangiomas are easily misdiagnosed because of their relative rarity and because they manifest no specific clinical findings, especially in the head and neck region. Aim and Objectives: To report a rare case of intramuscular hemangioma of the masseter muscle treated in our hospital. Materials and Methods: A 51-year-old man had multiple hard, firm, and immovable facial tumors on the left side of his face for 5 years without pain, numbness, facial palsy, or discharge. Magnetic resonance imaging (MRI) showed several heterogenous nodular tumors with well-defined margins in the left masseter muscle. An intramuscular hemangioma of the left masseter muscle with phlebolith formation was suspected. The main tumor and phleboliths were excised while the patient was under general anesthesia. Results: Both the marginal mandibular branch of the facial nerve and the facial artery were preserved. Postoperative results were satisfactory. Conclusion: With good history-taking, physical examination, and MRI scan, intramuscular hemangiomas of the masseter muscle can be satisfactorily diagnosed and excised, using a submandibular incision, without injuring the facial nerves or arteries.

並列關鍵字

intramuscular hemangioma ； masseter muscle ； phlebolith