CLINICALLY UNSUSPECTED VENOUS MALFORMATIONS LIMITED TO THE SUBMANDIBULAR TRIANGLE - CT FINDINGS

PURPOSE: To present the CT characteristics of histologically confirmed venous vascular malformations limited to the submandibular triangle i n patients without clinical stigmata of venous vascular malformations. METHODS: The clinical records and CT scans of five women with venous vascular malformations limited to the submandibular triangle were revi ewed. Patients ranged from 39 to 70 years of age. None of the patients had a history of malignant tumors. All patients presented with a soli tary suprahyoid neck mass. None of the patients demonstrated cutaneous manifestations of venous vascular malformation. RESULTS: Contrast-enh anced CT scans in all five patients demonstrated a lobulated, heteroge neously enhancing, well-circumscribed solid mass, separable from the s ubmandibular gland, Areas of contrast enhancement within each mass wer e isodense to the internal jugular vein in four of five cases. Only tw o of five lesions demonstrated focal calcifications. Excisional biopsy (two patients) demonstrated pathologic features compatible with venou s vascular malformation, Fine needle aspirations (three patients) yiel ded venous blood or blood-tinged fluid. CONCLUSIONS: Venous vascular m alformations may present as isolated neck masses in adults without typ ical clinical stigmata. Clues to the CT diagnosis include a lobulated appearance to the mass with intense but heterogeneous contrast enhance ment. This appearance, in combination with results of fine needle aspi ration, may be sufficiently diagnostic to preclude excisional biopsy.