Gingival metastasis of angiosarcoma of the breast as a first manifestation of spreading disease: Case report and review of the literature

Spec Care Dentist. 2024 Mar-Apr;44(2):458-464. doi: 10.1111/scd.12896. Epub 2023 Jun 21.

Abstract

Background: Angiosarcoma is an aggressive malignant neoplasm of vascular origin. Oral metastases of angiosarcoma are rare and have a non-specific clinical presentation, thus the diagnosis may be challenging.

Case report: Herein we report a case of a 34-year-old female patient after treatment of a high-grade angiosarcoma of the breast, who presented an asymptomatic bleeding purplish nodule in the maxillary interdental papilla between the first and second premolar. A biopsy was performed, and the histological examination revealed infiltration by malignant neoplasm of epithelioid and fusocellular pattern. Immunohistochemical analysis demonstrated that neoplastic cells were positive for ERG and CD31, and negative for cytokeratins AE1/AE3, confirming the diagnosis of metastatic angiosarcoma. After investigation, multiple metastases were discovered. The patient is under management with chemotherapy and palliative radiotherapy for the bone lesions.

Conclusion: Metastases should be considered in the differential diagnosis of oral lesions in patients with a previous history of cancer. Due to the morphology of angiosarcomas, the metastatic lesions may resemble benign vascular lesions, therefore, biopsy is mandatory to exclude malignancy.

Keywords: angiosarcoma; metastasis; oral.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Adult
  • Breast Neoplasms*
  • Female
  • Gingiva / pathology
  • Hemangiosarcoma* / diagnosis
  • Hemangiosarcoma* / pathology
  • Hemangiosarcoma* / therapy
  • Humans

Supplementary concepts

  • Angiosarcoma of the breast