Cavernous hemangioma with multiple phleboliths of the parotid gland in adult masquerading assialolithiasis

Objectives: Hemangiomas account for 0.4%-0.6% of all tumors of the parotid gland and are extremely rare in adults. Changes in blood flow dynamics within hemangiomas result in thrombus formation and phleboliths. We present a case of cavernous hemangioma with multiple phleboliths of the parotid gland masquerading assialolithiasis in an adult patient. Methods: A 43-year-old woman visited our hospital, presenting with a 3-year history of a slowly progressive painless mass at the left infraauricular area associated with intermittent swelling episodes related to meals. Computed tomography revealed multiple calcified nodules located within the enlarged, contrastenhanced left parotid gland. The patient subsequently underwent total parotidectomy. Results: Cavernous hemangioma with multiple phleboliths of the parotid gland was diagnosed. The patient recovered well from the surgery and was disease free at the most recent follow-up, 10 years later. Conclusions: No previous case reports have described a cavernous hemangioma with multiple phleboliths of the parotid gland. This condition requires further study because its rarity, clinical presentation, and imaging features often lead physicians to a misdiagnosis of sialolithiasis. It emphasizes that the possibility of a cavernous hemangioma should be considered in the differential diagnosis of parotid tumors when multiple intraglandular calcification nodules are observed in imaging studies.