Hemangioma occurs most frequently in the head and neck region, but hemangioma in the buccal fat pad region is rare. Here, a case of venous hemangioma with phleboliths in buccal fat pad region is reported. A 22-year-old female consulted the Department of Oral Surgery, Dental Hospital, Hokkaido University with a chief complaint of swelling in her right cheek. MRI showed a mass in the buccal fat pad extending to infratemporal fossa. The lesion had mixed iso-and hight-signal intensities on T 2 WI, but flow voids in the lesion were not seen on proton WI. Plain CT showed the lesion with several round calcifications. Angiography did not demonstrate the feeding vessels or venous pooling of the tumor. The lesion was clinically diagnosed as a buccal hemangioma. It was removed intraorally under general anesthesia. A part of the lesion consisted of mainly small blood vessels conglomerated like a strawberry and the remaining part was a mixture of vessels and fat tissue. Soft X-ray of the extirpated material revealed several round calcified foci. Histologically, the tumor consisted mainly of numerous vessels within adipose tissue of the buccal fat pad. Mature smooth muscle fibers were observed in the outer portion of blood vessels accompanied by phleboliths in some areas. The lesion was diagnosed to be a venous hemangioma with phleboliths.
