2017 Volume 63 Issue 5 Pages 262-266
Vascular malformation frequently occurs in the head and neck region. It is an extremely rare entity in the buccal space and pterygopalatine fossa. In this report, we describe a case of venous malformations (VM) extending from the buccal space to pterygopalatine fossa. The patient was a 54-year-old woman who presented with nerve palsy of the right maxillary gingiva in the molar region as well as the right buccal mucosa. Contrast-enhanced computed tomography revealed a mass lesion extending from the right buccal space to the pterygopalatine fossa, which compressed the posterior wall of the maxillary sinus. Magnetic resonance imaging revealed hypointensity equivalent to that of muscle on T1-weighted images and lobulated hyperintensity on fat-suppressed T2-weighted images. The clinical and laboratory findings indicated a diagnosis of pleomorphic adenoma or schwannoma. Surgical excision was performed by a maxillary sinus approach with the patient under general anesthesia. Furthermore, the external carotid artery was visualized to provide for massive bleeding. VM was definitively diagnosed. The postoperative course was uneventful for 2 years after surgery, with no evidence of recurrence. No clinical studies have reported VM extending from the buccal space to pterygopalatine fossa in association with nerve palsy.
