A female infant aged 2 months presented with progressive swelling in the left preauricular region since birth. There was a blueish discoloration this area. There were no additional clinical or laboratory findings, such as fever or malnutrition. A parotid gland ultrasound (US) scan was performed with a preliminary diagnosis of acute parotitis and infantile haemangioma. The scan showed significant enlargement and diffuse hypervascularity in the left parotid gland. The right parotid gland was normal (Fig. 1). The patient received a diagnosis of infantile haemangioma, as there was no evidence of infection, and treatment with propranolol was initiated. At the 3-month follow-up, the size and vascularisation of the haemangioma had decreased (Fig. 2).
Parotid infantile haemangioma is a rare benign tumour that usually develops in the first 6 months of life. It is associated with risk factors including female sex, low birth weight and older maternal age. Bluish discoloration of the skin is a common finding. Although its presentation may overlap with that of acute parotitis, it can be managed without surgery or a biopsy based on typical US findings combined with typical clinical findings.1,2 Other conditions to include in the differential diagnosis are cystic lymphatic malformation, solitary infantile myofibromatosis and sialoblastoma. Propranolol is the first-line treatment with generally satisfactory results. Surgical treatment is preferred in haemangiomas that do not respond to medical management or with complications.2,3
