Intra-masseteric venous malformation with phleboliths – a rare case report

Background: Intramuscular vascular malformations are uncommon tumours in the head and neck region. The masseter muscle is the most common site. Approximately 40% of the venous malformations are located in the head and neck region and occasionally are associated with phleboliths. Because of their rare occurrence, deep location and unfamiliar presentation, these malformations are often difficult to diagnose and treat subsequently. Objective: The objective of the study is to formulate a correct diagnosis and treatment plan when this type of lesion is encountered to prevent untoward complications or recurrence. Case Report: We present a case of a middle aged lady, presenting with secondarily infected intra masseteric venous malformation with phleboliths. The lesion was excised in toto along with the masseter muscle and the patient was followed up for 6 months. Conclusion: Any lesion in the region of the parotid or angle-ramus must be evaluated thoroughly prior to surgery. In cases of Intra masseteric venous malformations, where surgery is the primary option, total masseteric excision should be the treatment of choice as there is negligible cosmetic or functional disability, a better chance of clearance and reduced incidence of recurrence.