title: Presumptive intramuscular hemangioma of the masseter muscle.
abstract: BACKGROUND
  Hemangioma is a benign vascular proliferation. Intramuscular hemangiomas are rare, accounting for less than 1% of all hemangiomas, and occur normally in the trunk and extremities. Approximately 10-20% of intramuscular hemangiomas are found in the head and neck region, most often in the masseter muscles. The typical clinical characteristic is a painful soft tissue mass without cutaneous changes. Currently, MRI is the standard imaging technique for diagnosing soft-tissue hemangioma. The optimal management is the surgical resection.
  
  
  METHODS
  We report a case of 34-year-old male patient consulted for a swelling of 1 year evolution, around the parotid region. On physical examination, a soft, well-contoured lesion of about 2 cm on its long axis was found. MRI showed a space-occupying lesion in the left masseter muscle, with intermediate signal intensity on T1-weighted images and hyperignal intensity on T2-weighted images, containing nodular hypointense foci corresponding to calcification. The presumptive diagnosis of an intramasseteric hemangioma with phlebolith was made based on these findings. The patient was informed about her condition, and treatment options were discussed; however, the patient elected to forgo treatment at that time.
  
  
  CONCLUSIONS
  The possibility of an IMH should be included in the differential diagnosis of any intra-masseteric lesion. The appropriate radiologic examinations especially MRI can enhance accurate preoperative diagnosis; the treatment of choice should be individualized in view of the clinical status of the patient.
authors.affiliation: Department of Radiology, University Hospital Hassan II, Fes City, Morocco.
authors.forename: Badreeddine
authors.initials: B
authors.lastname: Alami
authors.affiliation: Department of Radiology, University Hospital Hassan II, Fes City, Morocco.
authors.forename: Youssef
authors.initials: Y
authors.lastname: Lamrani
authors.affiliation: Department of Radiology, University Hospital Hassan II, Fes City, Morocco.
authors.forename: Omar
authors.initials: O
authors.lastname: Addou
authors.affiliation: Department of Radiology, University Hospital Hassan II, Fes City, Morocco.
authors.forename: Meryem
authors.initials: M
authors.lastname: Boubbou
authors.affiliation: Department of Radiology, University Hospital Hassan II, Fes City, Morocco.
authors.forename: Imane
authors.initials: I
authors.lastname: Kamaoui
authors.affiliation: Department of Radiology, University Hospital Hassan II, Fes City, Morocco.
authors.forename: Mustapha
authors.initials: M
authors.lastname: Maaroufi
authors.affiliation: Department of Radiology, University Hospital Hassan II, Fes City, Morocco.
authors.forename: Nadia
authors.initials: N
authors.lastname: Sqalli
authors.affiliation: Department of Radiology, University Hospital Hassan II, Fes City, Morocco.
authors.forename: Siham
authors.initials: S
authors.lastname: Tizniti
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D006391:Hemangioma; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008406:Masseter Muscle / Q000000981:diagnostic imaging / Q000473:pathology*; D019042:Muscle Neoplasms / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed