CASE REPORTS   

Italian Journal of Maxillofacial Surgery 2008 August;19(2):99-106

Copyright © 2008 EDIZIONI MINERVA MEDICA

language: English

Surgical approach to the masticator space: wide excision for an hemangiopericytoma

Pizzigallo A. ¹, Mazzoni S. ¹, Cipriani R. ², Marchetti C. ³

¹ Maxillofacial Surgery Unit University Medical Center of Bologna, Bologna, Italy 2 Plastic Surgery Unit, University Medical Center of Bologna, Bologna, Italy 3 Department of Maxillofacial Surgery University Medical Center of Bologna, Bologna, Italy

A hemangiopericytoma is an uncommon benign vascular tumor. Reports concerning hemangiopericytoma into the pterigoid space are rare. As a rule, its treatment is surgical, and the surgical approach to the masticator space depends on the size and extension of any neoplasm developing in this space. We describe a case of a 70-year-old woman presented with a 6-month history of progressive pain in the left temporomandibular joint region. Preoperative imaging study showed lobular mass arising from the left masticator space involving the pterygoid and masseter muscles and expanding under the zygomatic arch into the left infratemporal and temporal fossae. The tumor was removed through a combined transmandibular and hemicoronal approaches To excise the hemangiopericytoma, a coronal approach together with Attenborough’s osteotomy of the zygoma was used. According to the authors this combined approach was the most appropriate for removing a deep tumor into the masticator space. Other possible surgical options are also discussed.