Clin Exp Otorhinolaryngol.  2011 Dec;4(4):207-209.

Venous Hemangioma of Parapharyngeal Space with Calcification

Affiliations
  • 1Department of Otorhinolaryngology-Head and Neck Surgery, The Catholic University of Korea College of Medicine, Seoul, Korea. hnsdi@catholic.ac.kr

Abstract

A hemangioma of the parapharyngeal space (PPS) is an extremely rare tumor and is responsible for 0.5-1% of all tumors occurring in the PPS. We report a case of PPS venous hemangioma in a 49-year-old woman presenting with diffuse swelling in the submandibular region. A preoperative computed tomography (CT) scan showed a cystic mass with multiple calcifications in the PPS. The calcific nodules were round and about 2 mm in diameter. The hemangioma was completely resected via a transcervical approach. During surgery, we found several calcific nodules, which represented phleoboliths or areas of thrombosis with dystrophic calcification. Despite its rarity, a venous hemangioma of the PPS should be considered in a differential diagnosis when a cystic mass with calcification is found by CT scan. To our knowledge, this is the first reported case of a PPS venous hemangioma; we describe its pathognomonic findings on imaging.

Keyword

Parapharyngeal space; Hemangioma; Calcification

MeSH Terms

Diagnosis, Differential
Female
Hemangioma
Humans
Middle Aged
Thrombosis

Figure

  • Fig. 1 (A) Contrast-enhanced axial computed tomography scan shows a well-defined and hypoattenuating lesion, 4×3 cm in size, with two spotty calcifications (arrows), on the right parapharyngeal space. (B) The lesion shows low signal intensity on contrast-enhanced axial T1-weighted magnetic resonance images, and the three central areas of low signal intensity with peripheral rim enhancement correspond to the calcifications. (C) T2-weighted coronal magnetic resonance imaging shows that this lesion is hyperintense, making it easier to delineate from adjacent normal soft tissue.

  • Fig. 2 (A) Microscopic examination revealed that dilated, thick-walled blood vessels were scattered, and some of these vessel were thrombosed (H&E, ×100). (B) A thick muscular-walled vessel containing calcification and thrombus (H&E, ×200).


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