Parotid infantile hemangioma

Parotid infantile hemangiomas are the most common parotid tumor of childhood. They usually run a characteristically benign course.

Epidemiology

The median age at diagnosis is 4 months ¹. There is a female preponderance with a male: female ratio of 1:3.

Clinical presentation

Presents as an enlarging parotid mass in an infant that was not present at birth. a cutaneous component (e.g. strawberry lesion) may be present. They can occasionally act as significant vascular shunts if they do not involute.

Radiographic features

Ultrasound

• homogeneous echogenic parotid mass
  • lobulated
  • fine echogenic internal septations
  • replaces or expands parotid tissue
• large internal vessels
  • rarely flow only seen on gray-scale as it is too low to be seen on Doppler

MRI

• T1: intermediate signal, between that of muscle and fat
• T2: hyperintense
  • prominent flow voids
• T1 C+ (Gd): homogeneous enhancement

Treatment and prognosis

Surgery is usually avoided since there is a risk of facial nerve damage and most lesions resolve over time either spontaneously or with medical therapy ⁵.