A phlebolith in the anterior portion of the masseter muscle.

The differential diagnosis of a buccal soft tissue mass containing calcified bodies includes a phlebolith associated with a vascular lesion, such as a hemangioma with a calcified intravascular thrombus, and diseases such as sialolithiasis, traumatic myositis ossificans, calcified acne lesion, neoplasm, and calcified lymph nodes, including tuberculosis. The appearance of the calcified bodies on plain radiographs may help to differentiate these entities. Computed tomography, magnetic resonance imaging, and ultrasonography are also useful for differentiating the soft tissue lesions. We report a 17-year-old girl with a small mass containing a calcified body in the anterior portion of the masseter muscle. The mass was resected surgically and evaluated histologically, confirming the diagnosis of phlebolith. We also discuss the differential diagnosis of a buccal soft tissue mass containing calcifications and suggest that the immunolocalization of CD31 at capillaries in the mass may help to diagnose as a phlebolith.