BACKGROUND: A 70-year-old female smoker self-presented to the DDUH emergency department with an anterior maxillary soft tissue mass that had gradually increased in size. She gave a history of localised infection in the anterior maxilla over the previous eight months, treated with antibiotics. One month prior to presentation she attended a dentist and had the bridge in anterior maxilla sectioned and two roots removed. The bridge had been placed 10 years previously and was followed by root canal treatment of an upper left canine tooth. A conservative excisional biopsy was performed.
AIM: To present a rare case of synchronous epithelioid angiosarcoma occurring in the maxilla and oropharynx.
RESULTS: Histology showed ulcerated squamous mucosa overlying a proliferation of malignant epithelioid cells forming vascular channels with hob-nailing, brisk mitoses, and extravasated red blood cells. The neoplastic cells were positive for MNF116, CD31 and ERG, consistent with epithelioid angiosarcoma. At this point, a whole-body PET-CT was performed and the patient was found to have an intensely FDG-avid mass in the left oropharyngeal tonsil. Tonsil biopsy confirmed epithelioid angiosarcoma.
CONCLUSION: This is an exceedingly rare case of dual-site synchronous presentation of epithelioid angiosarcoma occurring in the maxilla and oropharynx which, to our knowledge, has never before been reported.