Hemangioendothelioma of the parotid gland in infants: sonography and correlative MR imaging.

BACKGROUND AND PURPOSE Hemangioendothelioma is the most common parotid gland tumor of childhood, and is diagnosed on clinical grounds, supported by imaging findings. Previous work has suggested that MR is the best imaging technique for assessment of parotid hemangioendothelioma. Demonstration of a reliable sonographic appearance would reduce the need for MR imaging in infants with this lesion. METHODS We performed high-frequency sonography (including color Doppler and power Doppler imaging) in three patients, each with a diagnosis of parotid hemangioendothelioma confirmed by clinical follow-up. Two patients were also examined with MR imaging and labeled red cell scintigraphy. RESULTS All sonographic studies showed a homogeneous mass enlarging and replacing most or all of the visualized parotid gland, with a lobular internal structure, fine echogenic internal septations, and a mildly lobulated contour. Color Doppler and power Doppler imaging showed extremely high vascularity within the mass. Correlative MR images in two infants showed a well-defined lesion with uniform intense contrast enhancement. Labeled red cell scintigraphy showed a well-defined area of intense activity. CONCLUSION In the presence of a typical clinical history, sonography and clinical follow-up alone may prove to be sufficient for safe management of parotid hemangioendothelioma. MR imaging or labeled red cell scintigraphy may only be required if the sonographic features are atypical. These findings require confirmation in a larger series of patients.