Excision of a Solitary Neurofibroma in the Right Masseter Muscle via a High Perimandibular Approach: A Case Report and Review of the Literature.

We present a case of solitary neurofibroma in the masseter muscle that was excised via the high perimandibular approach (HPMA). A 52-year-old Japanese man complained of an uncomfortable feeling in his right buccal region. On examination, the buccal mucosa appeared normal, and overall, there were no skin disorders on the patient's body. Computed tomography revealed a well-defined 33 × 22-mm mass in the right masseter muscle showing a low density in the center and a slightly higher density at the margin of the mass. Magnetic resonance imaging also showed a hyperintense area on T1-weighted and T2-weighted images in the masseter muscle. An excisional biopsy was scheduled for the diagnosis of the intramasseteric mass. It was performed via the HPMA with the patient under general anesthesia. The final diagnosis was a neurofibroma. The patient recovered after the surgery without postoperative complications, including facial nerve damage and trismus. He was satisfied with the esthetic outcome, and the tumor has not recurred over a 24-month follow-up period. Altogether, these outcomes indicate that the HPMA is an effective and useful option for excision of a tumor in the masseter muscle.