Unilateral Facial Swelling in a One-Month-Old Male - An Atypical Presentation of Infantile Hemangioma: Case Report.

Introduction: Infantile hemangiomas are common benign vascular tumors in the pediatric population, but they rarely present as unilateral facial swelling in infants, making such cases atypical and warranting further investigation. This case report presents a one-month-old male with unilateral facial swelling, raising suspicion for an atypical infantile hemangioma and possible PHACE syndrome, which includes posterior fossa malformations, hemangioma, arterial anomalies, coarctation of aorta or cardiac defects, and eye abnormalities.

Case presentation: A one-month-old male presented with right-sided facial swelling without systemic symptoms. Initial imaging suggested mild parotitis, but the persistence and progression of swelling led to a reassessment, ultimately diagnosing a hemangioma.

Discussion: This case emphasizes the need for early imaging and multidisciplinary care in atypical cases to address potential syndromic associations, such as PHACE syndrome, which can carry significant morbidity if overlooked. Treatment with propranolol gradually reduced swelling, and multidisciplinary follow-up is ongoing to monitor for complications.