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KMID : 1033720190200060388
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Archives of Craniofacial Surgery
2019 Volume.20 No. 6 p.388 ~ p.391
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Intramasseteric schwannoma treated with facelift incision and retrograde facial nerve dissection
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Hwang Jae-Ha
Lee Dong-Gyu
Sim Ho-Seup
Kim Kwang-Seog
Lee Sam-Yong
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Abstract
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Schwannoma is a slow-growing, well-demarcated, benign soft tissue tumor of the peripheral nerve sheath. It commonly develops in the head and neck region, usually in the parapharyngeal space. In this case, a 42-year-old woman visited the outpatient department to manage a painless mass on her left cheek. She had no history of concern and no neurological symptoms were observed. In the enhanced computed tomography scan, a 2.8 × 2.8 × 1.8 cm, heterogeneously enhanced tumor was detected in the left masseter muscle. A tumor resection under general anesthesia was planned. For the resection, a facelift incision was chosen; branches of the facial nerve were identified and retrogradely dissected. A well-marginated, yellowish, solid mass was found in the left masseter muscle. The mass was excised and given a histopathological diagnosis of schwannoma. A definite diagnosis of schwannoma, originating in the masseter muscle, is difficult to arrive at with radiographic findings alone; it is often misdiagnosed as intramuscular hemangioma. Histopathological examinations, including fine-needle aspiration or histological biopsy after surgery, are necessary. Using a facelift incision with retrograde facial nerve dissection, tumor resection in an intramasseteric lesion can be performed efficiently, without nerve damage, or leaving conspicuous scars on the face.
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KEYWORD
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Masseter muscle, Neurilemmoma, Rhytidoplasty
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