title: Mesenchymal hamartomas of the pediatric head and neck.
abstract: We describe the fifth published report of a mesenchymal hamartoma presenting as a cheek mass. A 5-month-old infant was brought to our institution for evaluation of an enlarging left-sided congenital cheek mass. Over time, the lesion had begun to cause significant facial asymmetry and oral incompetence. Radiologic imaging revealed an approximate 2.5 × 3.5-cm, noncystic lesion located in the left buccal space, separate from the mandible and surrounding the salivary glands. Magnetic resonance imaging (MRI) sequences demonstrated an isointense, T1-weighted lesion with avid gadolinium uptake, and increased intensity of T2-weighted sequences. The patient subsequently underwent biopsy and subtotal resection through a left gingivobuccal incision with the goal of improving lip contour and facial symmetry. Histologic examination revealed an admixed arrangement of mature smooth muscle, vascular, adipose, and neural tissue elements within a slightly myxoid stroma, consistent with a mixed mesenchymal hamartoma. An 8-month postoperative MRI demonstrated near-total removal without evidence of regrowth. While rare, hamartomas should be included in the differential diagnosis of a slow-growing pediatric head and neck mass. Gross total resection may provide cure; however, given this lesion's benign nature, less-than-complete resection should be considered when lesions infiltrate opposing critical structures. Thorough clinical and histologic evaluation is critical to avoid overly aggressive treatment and unnecessary morbidity.
authors: Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, 200 First St., SW, Rochester, MN 55905, USA. ent.carlson@gmail.com
authors: Matthew L
authors: ML
authors: Carlson
authors: Amy M
authors: AM
authors: Saleh
authors: Keith J
authors: KJ
authors: Kaplan
authors: Shelagh A
authors: SA
authors: Cofer
mesh_terms: D006222:Hamartoma / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007223:Infant; D007229:Infant Welfare; D008648:Mesoderm / Q000473:pathology*