Download PDF
CC BY-NC-ND 4.0 · International Journal of Practical Otolaryngology 2020; 03(01): e10-e15
DOI: 10.1055/s-0040-1713649
Case Report

A Case Report of Bulky Venous Malformation in the Parapharyngeal Space

Yuki Sato
1   Department of Otorhinolaryngology, Hiroshima Prefectural Hospital, Hiroshima City, Hiroshima, Japan
,
Takao Hamamoto
2   Department of Otorhinolaryngology, Head and Neck Surgery, Hiroshima University Hospital, Hiroshima City, Hiroshima, Japan
,
Takashi Ishino
2   Department of Otorhinolaryngology, Head and Neck Surgery, Hiroshima University Hospital, Hiroshima City, Hiroshima, Japan
,
Tsutomu Ueda
2   Department of Otorhinolaryngology, Head and Neck Surgery, Hiroshima University Hospital, Hiroshima City, Hiroshima, Japan
,
Masay Takumida
2   Department of Otorhinolaryngology, Head and Neck Surgery, Hiroshima University Hospital, Hiroshima City, Hiroshima, Japan
,
Sachio Takeno
2   Department of Otorhinolaryngology, Head and Neck Surgery, Hiroshima University Hospital, Hiroshima City, Hiroshima, Japan
› Author Affiliations
› Further Information
   Permissions and Reprints

Abstract

Venous malformations commonly occur in the head and neck regions, in the mucous membrane of the nasal and oral cavities. Venous malformations are found in the extremities in 40% of cases, in the trunk in 20% of cases, and in the cervicofacial area in 40% of cases. However, they are rarely encountered in the parapharyngeal space. We report our experience of surgical treatment of a patient with this rare tumor. The patient was a 21-year-old man who presented with a left mandibular swelling and was admitted to a nearby hospital. He was referred to our hospital for examination and treatment. Contrast-enhanced computed tomography (CT) revealed a bulky tumor with some calcification in the parapharyngeal space; on contrast-enhanced CT, the tumor showed some enhanced effects in the arterial and venous phases. Additional enhancement magnetic resonance imaging (MRI) showed the lesion as low signal intensity on T1-weighted images and as high signal intensity on T2-weighted images, and contrast-enhanced MRI showed some enhanced effects of the lesion. Based on these findings, we suspected venous malformation and performed surgical excision. Histopathology confirmed the venous malformation, and the lesion was diagnosed as a cavernous angioma. Vascular malformations in the head and neck regions should be precisely diagnosed so that appropriate multimodality treatment can be undertaken.

Keywords

venous malformation - head and neck - parapharyngeal space


Publication History

Received: 15 May 2019

Accepted: 28 February 2020

Article published online:
01 September 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Georg Thieme Verlag KG
Stuttgart · New York

 

  • References

  • 1 Hassanein AH, Mulliken JB, Fishman SJ, Greene AK. Evaluation of terminology for vascular anomalies in current literature. Plast Reconstr Surg 2011; 127 (01) 347-351
    CrossrefPubMedGoogle Scholar
  • 2 Mulliken JB, Glowacki J. Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics. Plast Reconstr Surg 1982; 69 (03) 412-422
    CrossrefPubMedGoogle Scholar
  • 3 Mulliken JB, Young AE. Vascular Birthmarks: Hemangiomas and Malformations. Philadelphia, PA: WB Saunders; 1988
    Google Scholar
  • 4 Enjolras O, Mulliken JB. Vascular cutaneous anomalies in children: malformations and hemangiomas. Pediatr Surg Int 1996; 11 (5–6): 290-295
    CrossrefPubMedGoogle Scholar
  • 5 Loose DA. Surgical management of venous malformations. Phlebology 2007; 22 (06) 276-282
    CrossrefPubMedGoogle Scholar
  • 6 Riffat F, Dwivedi RC, Palme C, Fish B, Jani P. A systematic review of 1143 parapharyngeal space tumors reported over 20 years. Oral Oncol 2014; 50 (05) 421-430
    CrossrefPubMedGoogle Scholar
  • 7 Okamoto I, Kamata S, Miura K. , et al. A site of origin histopathological study on parapharyngeal space tumors. A review of 76 cases [in Japanese]. Nippon Jibiinkoka Gakkai Kaiho 2013; 116 (01) 27-30
    CrossrefPubMedGoogle Scholar
  • 8 Maeda H, Touyama M, Agena S, Matayoshi S. A surgical treatment of cavernous haemangioma in the parapharyngeal space. Head Neck Surg 2016; 26 (01) 109-113
    PubMedGoogle Scholar
  • 9 Mulliken JB, Fishman SJ, Burrows PE. Vascular anomalies. Curr Probl Surg 2000; 37 (08) 517-584
    CrossrefPubMedGoogle Scholar
  • 10 Dompmartin A, Vikkula M, Boon LM. Venous malformation: update on aetiopathogenesis, diagnosis and management. Phlebology 2010; 25 (05) 224-235
    CrossrefPubMedGoogle Scholar
  • 11 Dubois J, Soulez G, Oliva VL, Berthiaume MJ, Lapierre C, Therasse E. Soft-tissue venous malformations in adult patients: imaging and therapeutic issues. Radiographics 2001; 21 (06) 1519-1531
    CrossrefPubMedGoogle Scholar
  • 12 Trop I, Dubois J, Guibaud L. , et al. Soft-tissue venous malformations in pediatric and young adult patients: diagnosis with Doppler US. Radiology 1999; 212 (03) 841-845
    CrossrefPubMedGoogle Scholar
  • 13 Paltiel HJ, Burrows PE, Kozakewich HP, Zurakowski D, Mulliken JB. Soft-tissue vascular anomalies: utility of US for diagnosis. Radiology 2000; 214 (03) 747-754
    CrossrefPubMedGoogle Scholar
  • 14 Kakimoto N, Tanimoto K, Nishiyama H, Murakami S, Furukawa S, Kreiborg S. CT and MR imaging features of oral and maxillofacial hemangioma and vascular malformation. Eur J Radiol 2005; 55 (01) 108-112
    CrossrefPubMedGoogle Scholar
  • 15 Dompmartin A, Vikkula M, Boon LM. Venous malformation: update on aetiopathogenesis, diagnosis and management. Phlebology 2010; 25 (05) 224-235
    CrossrefPubMedGoogle Scholar
  • 16 Legiehn GM, Heran MK. Venous malformations: classification, development, diagnosis, and interventional radiologic management. Radiol Clin North Am 2008; 46 (03) 545-597 , vi
    CrossrefPubMedGoogle Scholar
  • 17 Moukaddam H, Pollak J, Haims AH. MRI characteristics and classification of peripheral vascular malformations and tumors. Skeletal Radiol 2009; 38 (06) 535-547
    CrossrefPubMedGoogle Scholar
  • 18 Vilanova JC, Barceló J, Smirniotopoulos JG. , et al. Hemangioma from head to toe: MR imaging with pathologic correlation. Radiographics 2004; 24 (02) 367-385
    CrossrefPubMedGoogle Scholar
  • 19 Heit JJ, Do HM, Prestigiacomo CJ. , et al; SNIS Standards and Guidelines committee. Guidelines and parameters: percutaneous sclerotherapy for the treatment of head and neck venous and lymphatic malformations. J Neurointerv Surg 2017; 9 (06) 611-617
    CrossrefPubMedGoogle Scholar
  • 20 Steiner F, FitzJohn T, Tan ST. Surgical treatment for venous malformation. J Plast Reconstr Aesthet Surg 2013; 66 (12) 1741-1749
    CrossrefPubMedGoogle Scholar
  • 21 Frigerio A, Tan OT. Laser applications for benign oral lesions. Lasers Surg Med 2015; 47 (08) 643-650
    CrossrefPubMedGoogle Scholar
  • 22 Marler JJ, Mulliken JB. Current management of hemangiomas and vascular malformations. Clin Plast Surg 2005; 32 (01) 99-116 , ix
    CrossrefPubMedGoogle Scholar