Intra-muscular haemangioma of the masseter: A clinical update and differential diagnosis of a rare entity.

The intramuscular haemangioma (IMH) is a rare variant of unknown aetiology and comprises 0.8% of soft tissue haemangiomas. Less than 20% of IMHs occur in the craniofacial region of which the masseter is the most common site. It presents as a non-specific, painful soft tissue enlargement in young adults. Symptoms common to vascular lesions usually are absent. Due to the paucity of clinical symptoms, advanced imaging techniques like MRIs are needed to clinch a definitive pre-operative diagnosis. The therapeutic modalities mentioned in the literature range from total surgical excision to non-surgical methods like cryotherapy, sclerotherapy, embolization and feeder vessel ligation. We present a case of an intra-massetric IMH in a 16-year-old male which was treated by total surgical excision with a follow up of 3 years. We also stress on the differential diagnosis of intra-massetric lesions and the key findings of the various imaging modalities available for IMH.