A 2 m old infant , born at 35 1/7 weeks of gestation via LSCS with BW 2610 g due to preterm PROM, came with sudden-onset bilateral buccal protrusions. NO trauma history previously, nor were any congenital disorders found.
What is this...!?
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What is this...!?
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▶️physical examination revealed bilateral protrusions that were normal in color & texture without bleeding, pus, or ulcer.
▶️With crying, the protrusions became more obvious..!
▶️With crying, the protrusions became more obvious..!
⚡️MRI showed lesions 2.9 cm in diameter over the left cheek & 2.7 cm over the right cheek with intact b/l buccinator muscle, presenting high signal in T1-weighted imaging view & low signal in fat-suppression view.
⚡️These were suspected to have extended from the buccal fat pad
⚡️These were suspected to have extended from the buccal fat pad
⚡️Under clinical observation, the mass ⏬slightly in size during hospitalization, & the pt was discharged.
⚡️The lesions had ⏬markedly when examined 2 mths later during an OPD visit & measured one-fourth in size at the age of 15 months.
⚡️The lesions had ⏬markedly when examined 2 mths later during an OPD visit & measured one-fourth in size at the age of 15 months.
⚡️The buccal fat pad, an anatomic structure btw the buccinator muscle medially & facial expression muscles laterally, plays a large role in cheek prominence of newborns & infants.
⚡️A buccal fat pad mass is rare in newborns
⚡️A buccal fat pad mass is rare in newborns
⚡️DDs include
▶️buccal tumor (fibroma, neuroma, hemangioma,
and their malignant counterparts),
▶️traumatic herniation, and
▶️nontraumatic herniation
▶️buccal tumor (fibroma, neuroma, hemangioma,
and their malignant counterparts),
▶️traumatic herniation, and
▶️nontraumatic herniation
Final Diagnosis:
Non traumatic Bilateral Buccal Fat Pad Herniation
Non traumatic Bilateral Buccal Fat Pad Herniation
▶️Incomplete maturation of the buccinator muscles induces the buccal fat pad to protrude into the oral cavity, especially during crying & laughing, & these herniations disappear when these actions are stopped.
▶️Following maturation of the muscles, the herniations will resolve.
▶️Following maturation of the muscles, the herniations will resolve.
▶️In the absence of🚩, it is reasonable to follow-up instead of performing surgical intervention.
▶️Because the buccal fat pad is intimately related to the masticatory muscles, facial nerve & parotid gland, these functions need to be monitored
▶️Because the buccal fat pad is intimately related to the masticatory muscles, facial nerve & parotid gland, these functions need to be monitored
In conclusion,
infant buccal fat pad herniation is very very rare but should be considered as one of the differential diagnoses of oral masses in infants.
Source: @ActaPaediatrica 10.1016/j.jpeds.2022.09.020
infant buccal fat pad herniation is very very rare but should be considered as one of the differential diagnoses of oral masses in infants.
Source: @ActaPaediatrica 10.1016/j.jpeds.2022.09.020
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