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Urabe R, Miyamae M, Minegishi Y, Nakai K. Surgical treatment for a giant venous malformation of the parotid area. J Surg Case Rep 2023; 2023:rjad591. [PMID: 37901607 PMCID: PMC10607195 DOI: 10.1093/jscr/rjad591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 10/08/2023] [Indexed: 10/31/2023] Open
Abstract
This report discusses the surgical treatment of a giant parotid venous malformation (VM) that had grown beyond the dimensions of the parotid gland, causing significant displacement. Special attention was paid to identifying the facial nerve, which was found to traverse the surface of the VM. Although, in our case, the facial nerve ran superficially on the VM, it is possible that a portion of it penetrated the mass. A two-stage excision and revision surgery strategy was employed due to the complexity of assessing deformities after removing the giant lesion. During the initial surgery, the displaced superficial lobe of the parotid gland was repositioned to its original location and carefully laid over the facial nerve, ensuring its safety during the subsequent procedure.
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Affiliation(s)
- Ryotaro Urabe
- Department of Plastic and Reconstructive Surgery, University of Fukui Hospital, 23-3, Matsuokashimoaizuki, Eiheiji-cho, Fukui 910-1193, Japan
| | - Makoto Miyamae
- Department of Plastic and Reconstructive Surgery, University of Fukui Hospital, 23-3, Matsuokashimoaizuki, Eiheiji-cho, Fukui 910-1193, Japan
| | - Yoshiki Minegishi
- Department of Plastic and Reconstructive Surgery, University of Fukui Hospital, 23-3, Matsuokashimoaizuki, Eiheiji-cho, Fukui 910-1193, Japan
| | - Kunihiro Nakai
- Department of Plastic and Reconstructive Surgery, University of Fukui Hospital, 23-3, Matsuokashimoaizuki, Eiheiji-cho, Fukui 910-1193, Japan
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Fuad M, Goh BS, Lokman FL, Mohamad Yunus MR. Blue Parotid Unveiled: A Rare Case of Traumatic Hemorrhagic Parotid Lymphangioma in an Eight-Year-Old Boy. Cureus 2023; 15:e46415. [PMID: 37927667 PMCID: PMC10621628 DOI: 10.7759/cureus.46415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2023] [Indexed: 11/07/2023] Open
Abstract
Parotid lymphangioma is a benign lymphatic malformation commonly observed in infancy or early childhood. It often grows insidiously and presents as a painless, soft fluctuant mass. We report a case of an eight-year-old boy who was diagnosed from another center with right parotid lymphangioma of one-year duration. He presented with right painful preauricular swelling and trismus for nine days after a recent history of blunt trauma to the preauricular caused an acute expansion of the swelling and subsequently, the patient developed ipsilateral facial nerve palsy. Examination showed right preauricular swelling measuring about 6 x 6 cm that extended posteriorly until the mastoid region, superiorly until the zygoma, and inferiorly until the angle of the mandible, pushing the ear lobule anteromedially. There was bluish discoloration of the overlying skin. The swelling was warm and tender on palpation. Multiple shotty lymph nodes were palpable at the posterior triangle. Aspiration of the swelling revealed blood content, but it reaccumulated after a few hours. A magnetic resonance imaging (MRI) of the neck showed a lesion confined within the parotid gland. There was a presence of air-fluid level with dependent layers of hyperintense on the T1-weighted image (T1WI) and T2-weighted image (T2WI) with clumps of isointensity on T1WI, which are hypointense on T2WI, which is suggestive of acute-late subacute blood product. A diagnosis of lymphatic malformation complicated with hemorrhage was made. Hence, the patient underwent surgery for the evacuation of blood clot and right superficial parotidectomy. Histopathological examination of the intraoperative tissue biopsy revealed evidence of venolymphatic malformation of the parotid gland. Postoperatively, he was discharged home after three days. The facial nerve function recovered from House and Brackmann grade II to grade I three weeks after the surgery.
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Affiliation(s)
- Muizzuddin Fuad
- Otolaryngology - Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS
| | - Bee See Goh
- Otorhinolaryngology/Pediatrics Otorhinolaryngology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS
| | - Farah Liana Lokman
- Otolaryngology - Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS
| | - Mohd Razif Mohamad Yunus
- Otorhinolaryngology - Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS
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3
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Menon NN, Bharathi MB. Rare Presentation of Venous Malformation in Parapharyngeal Space. Indian J Otolaryngol Head Neck Surg 2023; 75:2453-2455. [PMID: 37636612 PMCID: PMC10447762 DOI: 10.1007/s12070-023-03683-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 03/05/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction Venous malformations are commonly seen in muscles like masseter, temporalis, tongue musculature, oral and airway mucosa in the head and neck region but is rarely seen in parapharyngeal space. Case Summary We report a case of a 60 year female patient who presented with foreign body sensation of throat, sticky sensation and dysphagia to solids for 2 years. She was subjected to relevant investigations including MRI and USG guided FNAC. Following which she underwent endoscopic parapharyngeal space tumour excision and specimen was sent for HPE. Post operatively patient is doing well and symptomatically better. She is being followed up on regular basis. Conclusion Parapharyngeal space tumours accounts for only 0.5% of head and neck tumours, of which 70 to 80% are benign and the rest are malignant. Out of the benign tumours of parapharyngeal space we should also keep in mind rare tumours like venous malformations.
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Affiliation(s)
- Nandini N Menon
- Department of Surgical oncology, BLK- MAX Super speciality hospital, Pusa road, Rajendra Place, Delhi, 110005 India
| | - M B Bharathi
- ENT and Head and Neck surgery, JSS Medical college and hospital, Mysore, Karanataka India
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Vascular Abnormalities of the Parotid Region: An Uncommon Presentation of a Common Condition—A Case Series. Diagnostics (Basel) 2022; 12:diagnostics12092236. [PMID: 36140637 PMCID: PMC9497633 DOI: 10.3390/diagnostics12092236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 09/04/2022] [Accepted: 09/14/2022] [Indexed: 11/16/2022] Open
Abstract
A variety of non-neoplastic diseases and benign and malignant lesions may involve parotid glands. In clinical practice, effective diagnosis is crucial to ensure proper treatment and achieve a good therapeutic effect. Unclear anamnesis and short medical history are factors that make diagnosis difficult, especially when cancer should be excluded. We present a case series of four patients who reported to the outpatient clinic with a unilateral nodule in the parotid region. The clinical presentation prevented an unequivocal diagnosis. The suspicion of a neoplastic disease resulted in profound diagnostics, including repeated cytology, ultrasound and magnetic resonance examination. Combining all the acquired information and follow-up, or a histopathologic examination, facilitated the final diagnosis. In all cases, thrombosis was diagnosed. We then analysed the diagnostic process and the associated difficulties. When thrombosis in vascular malformation occurs in the parotid region, it may have an unclear clinical and radiological presentation. Such an image can imitate both benign and malignant tumours. Ambiguous imaging in conjunction with blood cells in cytology should result in the inclusion of thrombosis in vascular malformations in the differential diagnosis.
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The Rare Cases of Parotid Gland Arteriovenous Malformations. Case Rep Otolaryngol 2021; 2021:6072155. [PMID: 34513104 PMCID: PMC8429032 DOI: 10.1155/2021/6072155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 08/24/2021] [Indexed: 01/09/2023] Open
Abstract
Arteriovenous malformation (AVM) results from errors in vascular development during embryogenesis; absent capillary beds lead to shunting directly from the arterial to venous circulation. Although it is common in the head and neck region, AVMs located in the parotid gland are quite rare. Here, we report two cases of arteriovenous malformation of the parotid gland that presented to our out-patient setup with swelling in the parotid region and were diagnosed as arteriovenous malformation on histopathological study after surgical resection.
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Velez Torres JM, Duarte EM, Diaz-Perez JA, Leibowitz J, Weed DT, Thomas G, Sargi Z, Civantos FJ, Arnold DJ, Gomez-Fernandez C, Montgomery EA, Rosenberg AE. Mesenchymal Neoplasms of Salivary Glands: A Clinicopathologic Study of 68 Cases. Head Neck Pathol 2021; 16:353-365. [PMID: 34251596 PMCID: PMC9187808 DOI: 10.1007/s12105-021-01360-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 07/06/2021] [Indexed: 12/13/2022]
Abstract
Salivary gland neoplasms are uncommon, and most exhibit epithelial differentiation. Mesenchymal neoplasms of the salivary gland are rare, and the incidence ranges from 1.9% to 5%. The aim of this study is to identify the types and clinical-pathological features of mesenchymal salivary neoplasm and review their differential diagnosis. A retrospective search for mesenchymal neoplasms of salivary glands from our institution's pathology archives from the 2004-2021 period and consultation files of one of the authors (AER) was performed. The clinical data were obtained from available medical records, and the histological slides and ancillary studies were retrieved and reviewed. We identified a total of 68 cases that form the study cohort. Thirty-five patients were male, and thirty-three patients were female, with a mean age of 48 years (range, 7 months-79 years), and the male to female ratio was 1:.94. Sixty-three (92.6%) of sixty-eight tumors were benign and included: 38 (56%) lipomas, 9 (13%) hemangiomas, 7 (10.3%) schwannomas, 3 (4.4%) neurofibromas, 3 (4.4%) lymphangioma, 2 (3%) solitary fibrous tumors, 1 (1.5%) myofibroma. Five of sixty-eight (7.4%) were malignant and included: 3 (4.4%) Adamantinoma-like Ewing sarcomas, 1 (1.5%) malignant peripheral nerve sheath tumor (MPNST), and 1 (1.5%) malignant solitary fibrous tumor. The involved sites included: parotid (55), submandibular gland (5), parapharyngeal space (5), buccal mucosa minor salivary gland (2), and sublingual gland (1). Sixty-seven patients underwent surgical resection. One patient with lymphangioma manifested a recurrence/persistence a week post-surgery. One patient with a parotid hemangioma developed post-operative numbness, and another patient developed chronic postauricular pain after surgery. Two patients with MPNST and one patient with adamantinoma-like Ewing sarcoma underwent neoadjuvant chemoradiation and were disease-free after treatment. The remaining 37 patients with available follow-up ranging from 7 days to 96 months (mean, 18 months) had a favorable outcome and were disease-free after treatment. Mesenchymal neoplasms of salivary gland are rare; most are benign and demonstrate adipocytic, endothelial, and schwannian differentiation; awareness of their development is important for adequate diagnosis. The mainstay of treatment is surgical excision, with the extent determined by tumor type. Adjuvant therapy is reserved for high-grade sarcomas and may be given in a neoadjuvant or adjuvant setting.
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Affiliation(s)
- Jaylou M. Velez Torres
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, 1400 NW 12th Avenue, Miami, FL 33136 USA
| | | | - Julio A. Diaz-Perez
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, 1400 NW 12th Avenue, Miami, FL 33136 USA
| | - Jason Leibowitz
- Department of Otolaryngology-Head and Neck Surgery, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL USA
| | - Donald T. Weed
- Department of Otolaryngology-Head and Neck Surgery, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL USA
| | - Giovanna Thomas
- Department of Otolaryngology-Head and Neck Surgery, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL USA
| | - Zoukaa Sargi
- Department of Otolaryngology-Head and Neck Surgery, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL USA
| | - Francisco J. Civantos
- Department of Otolaryngology-Head and Neck Surgery, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL USA
| | - David J. Arnold
- Department of Otolaryngology-Head and Neck Surgery, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL USA
| | - Carmen Gomez-Fernandez
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, 1400 NW 12th Avenue, Miami, FL 33136 USA
| | - Elizabeth A. Montgomery
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, 1400 NW 12th Avenue, Miami, FL 33136 USA
| | - Andrew E. Rosenberg
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, 1400 NW 12th Avenue, Miami, FL 33136 USA
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Zareena S, Dinesh KB, Narayanasami B, Marunraj G, Rekha A. Venous Malformation of the Parotid Gland. Int J Angiol 2019; 28:210-214. [PMID: 31452591 DOI: 10.1055/s-0039-1694296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Vascular malformations of the parotid gland are extremely rare. A 23-year-old female presented with tender parotid swelling with mild compressibility. Diagnosis was made by ultrasonogram and confirmed by magnetic resonance imaging. Facial nerve preserving surgical excision of the superficial parotid gland with infiltration of foam sclerosant was done.
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Affiliation(s)
- Shifa Zareena
- Department of General Surgery, Saveetha Medical College Hospital, Chennai, Tamil Nadu, India
| | - K B Dinesh
- Department of General Surgery, Saveetha Medical College Hospital, Chennai, Tamil Nadu, India
| | - Bharath Narayanasami
- Department of General Surgery, Saveetha Medical College Hospital, Chennai, Tamil Nadu, India
| | - G Marunraj
- Department of Vascular Surgery, Saveetha Medical College Hospital, Chennai, Tamil Nadu, India
| | - Arcot Rekha
- Department of General Surgery, Saveetha Medical College Hospital, Chennai, Tamil Nadu, India
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Palacios E, Gomez JS. Unusual Finding in a Chronic Parotid Mass. EAR, NOSE & THROAT JOURNAL 2019; 98:328-329. [PMID: 30955378 DOI: 10.1177/0145561319825668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Enrique Palacios
- 1 Department of Radiology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Juan S Gomez
- 1 Department of Radiology, Tulane University School of Medicine, New Orleans, LA, USA
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9
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Ginat DT. Imaging of Benign Neoplastic and Nonneoplastic Salivary Gland Tumors. Neuroimaging Clin N Am 2018; 28:159-169. [DOI: 10.1016/j.nic.2018.01.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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10
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Avignon S, Foletti JM, Collet C, Guyot L, Chossegros C. [Calcifications of the parotid space. A review]. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2017; 118:167-172. [PMID: 28391078 DOI: 10.1016/j.jormas.2017.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 11/22/2016] [Accepted: 03/15/2017] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Parotid lithiasis is the main cause of calcifications in the parotid space. However, there are many other less known causes. The aim of our study was to point out the non-lithiasic causes of calcifications in the parotid space. MATERIAL AND METHODS We conducted an exhaustive review of the literature by mean of PubMed, using the keywords "parotid" and "calcification" and limiting our analysis to the original articles in humans published in English and in French. Articles reporting about microscopic calcifications and who were not dealing with parotid calcifications were excluded. RESULTS Twenty articles met the inclusion criterions. Tumoral and non-tumoral local causes and systemic causes of parotid calcification were found. The way they revealed was variable. The main tumoral local causes were pleomorphic adenomas, salivary duct carcinomas and adenocarcinomas. The main non-tumoral local causes included vascular malformations and calcified parotid lymph nodes. The main systemic causes were chronic kidney diseases, HIV infection, chronic alcoholism, elevated levels of alkaline phosphatase and auto-immune diseases. DISCUSSION Eighteen different etiologies of parotid space calcifications could be identified. First line exploration of these lesions relies mainly on conventional radiography and ultrasound examination that are easily available. CT scan remains the reference examination.
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Affiliation(s)
- S Avignon
- Service de stomatologie et de chirurgie maxillo-faciale, CHU de la Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
| | - J-M Foletti
- Service de chirurgie maxillo-faciale, stomatologie et plastique, hôpital Nord, chemin des Bourrelys, 13015 Marseille, France
| | - C Collet
- Service de stomatologie et de chirurgie maxillo-faciale, CHU de la Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
| | - L Guyot
- Service de chirurgie maxillo-faciale, stomatologie et plastique, hôpital Nord, chemin des Bourrelys, 13015 Marseille, France
| | - C Chossegros
- Service de stomatologie et de chirurgie maxillo-faciale, CHU de la Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
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Jáuregui E, Kiringoda R, Ryan WR, Eisele DW, Chang JL. Chronic parotitis with multiple calcifications: Clinical and sialendoscopic findings. Laryngoscope 2016; 127:1565-1570. [PMID: 27861944 DOI: 10.1002/lary.26386] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 09/01/2016] [Accepted: 09/27/2016] [Indexed: 12/13/2022]
Abstract
OBJECTIVES/HYPOTHESIS To characterize clinical, imaging, and sialendoscopy findings in patients with chronic parotitis and multiple parotid calcifications. STUDY DESIGN Retrospective review. METHODS Clinical history, radiographic images and reports, lab tests, and operative reports were reviewed for adult patients with chronic parotitis and multiple parotid calcifications who underwent parotid sialendoscopy. RESULTS Thirteen of 133 (10%) patients undergoing parotid sialendoscopy for chronic sialadenitis had more than one calcification in the region of the parotid gland. Seven patients (54%) were diagnosed with immune-mediated disease from autoimmune parotitis (positive Sjögren's antibodies or antinuclear antibodies) or human immunodeficiency virus (HIV) disease. The six patients (46%) who did not have an immune-mediated disorder had most calcifications located anterior or along the masseter muscle. Eight of 13 patients (61%) had at least one calculus found in the parotid duct on sialendoscopy. Four patients (38%) had multiple punctate calcifications within the parotid gland, all of whom had either autoimmune parotitis or HIV. None of the proximal or punctate parotid calcifications posterior to the masseter were visualized on sialendoscopy. CONCLUSIONS Chronic parotitis in conjunction with multiple parotid calcifications is uncommon and was identified in 10% of our cohort. We contrast two classifications of parotid calcifications: 1) intraductal stones that cause recurrent duct obstruction and are often located within the main parotid duct along or anterior to the masseter and 2) punctate intraparenchymal parotid gland calcifications that are not visualized on sialendoscopy and may represent underlying inflammatory disease. LEVEL OF EVIDENCE 4 Laryngoscope, 127:1565-1570, 2017.
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Affiliation(s)
- Emmanuel Jáuregui
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco School of Medicine, San Francisco, California, U.S.A
| | - Ruwan Kiringoda
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A
| | - William R Ryan
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco School of Medicine, San Francisco, California, U.S.A
| | - David W Eisele
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, U.S.A
| | - Jolie L Chang
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco School of Medicine, San Francisco, California, U.S.A
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Khatib Y, Dande M, Patel RD, Gite V. Venolymphatic vascular malformation of the parotid gland extending into the parapharyngeal space: A rare presentation. J Oral Maxillofac Pathol 2016; 20:308-11. [PMID: 27601828 PMCID: PMC4989566 DOI: 10.4103/0973-029x.185917] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Vascular malformations (VMs) are structural malformations of vascular development causing soft tissue abnormality with functional and esthetic impairment. They are named by their predominant vessel type as arterial, venous, lymphatic or mixed types. VMs of the parotid gland are extremely rare and constitute a distinct entity of parotid pathology that requires specific diagnostic tools and management. Till 2013, only fifty cases of VMs of the parotid have been described in the literature. We present a case of a venolymphatic malformation of the parotid gland extending into the parapharyngeal space in a 21-year-old male who presented with a swelling on the left side of the face extending into the neck. Diagnosis was suggested by ultrasonography and computed tomography scan and was confirmed by magnetic resonance imaging examination. Complete surgical excision of the lesion was done with a favorable outcome. Diagnosis was confirmed based on histopathology and immunohistochemical studies.
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Affiliation(s)
- Yasmeen Khatib
- Department of Pathology, Dr. R. N. Cooper Hospital, Mumbai, Maharashtra, India
| | - Madhura Dande
- Department of Pathology, Dr. R. N. Cooper Hospital, Mumbai, Maharashtra, India
| | - Richa D Patel
- Department of Pathology, Dr. R. N. Cooper Hospital, Mumbai, Maharashtra, India
| | - Vinod Gite
- Department of ENT, Dr. R. N. Cooper Hospital, Mumbai, Maharashtra, India
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14
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Abstract
BACKGROUND Vascular malformations can mimic malignant tumors, and the coexistence of both types of lesions can limit and interfere with treatment. A consecutive series of vascular malformations that were treated and evaluated in a single institute and cases involving vascular anomalies combined with malignancies or malignancies that were treated as vascular anomalies were analyzed. OBJECTIVE Absolute ethanol is used in the treatment and management of vascular malformations and is sometimes administered before a definitive diagnosis has been obtained, despite the fact that some vascular lesions are subsequently revealed to be malignant tumors. This study discusses such cases. MATERIALS AND METHODS From January 2006 to August 2012, 139 patients were treated for vascular malformations at Nagasaki University Hospital and were followed up for a minimum of 1 year. RESULTS Four malignant lesions coexisted with or were misdiagnosed as vascular malformations, including a malignant peripheral nerve sheath tumor located in the chest, a hemangiopericytoma of the palate, an adenoid cystic carcinoma of the cheek, and a squamous cell carcinoma of the cheek. Thus, malignant lesions were detected in 2.88% of cases in which vascular malformations were preoperatively diagnosed. CONCLUSION When treating vascular malformations, it is advisable to be aware of the possibility of malignancy.
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