Intravascular papillary endothelial hyperplasia (Masson’s tumor) of the parotid gland: a case report and literature review

BACKGROUND: Intravascular papillary endothelial hyperplasia (IPEH), or Masson's tumor, is a rare benign vascular proliferation that uncommonly involves the parotid gland. METHODS: This report details the case of a 53-year-old female who presented with an 8-year history of a right parotid mass that exhibited significant growth over 2 years, accompanied by the development of multiple bluish cutaneous lesions in the subauricular and cervical region. RESULTS: Clinical and radiological evaluations were nonspecific. A cutaneous biopsy revealed a cavernous hemangioma. The patient underwent a superficial parotidectomy with complete facial nerve preservation. Histopathological examination of the parotid specimen confirmed a diagnosis of IPEH, characterized by papillary fronds lined by bland endothelial cells. Notably, one of the excised skin lesions also showed histological features of IPEH, alongside hemangioma. CONCLUSION: This case is exceptional as it represents a mixed-form IPEH arising in association with a preexisting vascular lesion and demonstrates rare multifocal involvement of both the parotid gland and the skin. It underscores the diagnostic challenge this entity poses, often mimicking other salivary gland tumors, and highlights histopathology as the diagnostic cornerstone. Complete surgical excision remains the treatment of choice and is curative. This case contributes to the limited literature on parotid IPEH and illustrates its potential for multifocal presentation in the context of underlying vascular pathology, making this the seventh documented case in the literature.