Angiosarcoma of Maxillary Sinus: A Case Report

Abstract

Introduction: Angiosarcoma is an extremely rare neoplasm of maxillary sinus. We report a case of angiosarcoma of the maxillary sinus together with the treatment of surgery and radiotherapy using cyberknife. Case: An 87-year-old woman was referred to oral surgery, with a swelling on the right side of the cheek. Present history revealed that the swelling was gradually growing over a period of 1 month and was not associated with pain, tenderness or discharge. The patient stated that the swelling was becoming larger ever since. The patient experienced more swelling when she tilted her head down. The skin over the diffuse swelling appeared normal. Intraoral examination revealed a mass, extending from buccal vestibule to the edentulous alveor process of the corresponding to maxillary right premolars. The mass was smooth surface, soft in consistency, painless and no pulsation on palpation, and measured about 3null3 cm. There was no pulsation. Examination of the cervical lymph nodes was unremarkable with no evidence of lymphadenopathy. Radiographic views showed radiopacity in the right maxillary sinus and nasal cavity as well as the absence of a right maxillary-tuberosity line. A CT scan showed an illdefined mass with nonhomogeneous and increased density occupying the right maxillary sinus extending to the pterygopalatine fossa. Destruction of the posterior maxillary sinus wall with invasion of the ethomoidal sinus was observed. Since the tumor had started to grow rapidly in 1 month and spontaneous bleeding was fond, a malignant tumor was strongly suspected, but it was different from a squamous cell carcinoma. The result of biopsy was angiosarcoma. Postoperative radiotherapy using cyberknife after cytoreductive surgery was carried out. An aggressive growth was well controlled and a good response was noted 10 months after radiotherapy. Conclusion: Angiosarcoma is an extremely rare neoplasm of maxillary sinus. We report a case of angiosarcoma of the maxillary sinus together with the treatment of cytoreductive surgery and radiotherapy using cyberknife. Radiotherapy using cyberknife is an effective treatment for angiosarcoma of maxillary sinus.