Epithelioid angiosarcoma of the masseter muscle: a rare clinicopathological diagnosis

Abstract

Epithelioid angiosarcoma (EA) is a subtype of angiosarcoma which is a rare tumor of endothelial origin. Here, we report a case of 15-year-old boy who presented with soft tissue mass lesion in the parotid region mimicking as a benign parotid tumor. Cytology was suggestive of inflammatory swelling. Patient underwent superficial parotidectomy along with the wide excision of the swelling. On histopathology, it was diagnosed as EA. To the best of our knowledge this is the first case report of epithelioid angiosarcoma of the masseter.

Keywords: chemotherapy; epithelioid angiosarcoma; masseter muscle; parotid; radiotherapy.

Figure 1

(a) Markings showing the mass and the modified Blair’s incision in the preauricular region. (b): CT scan showing hypodense lesion occupying the left masseter muscle. (c) Intraoperative picture showing facial nerve and its branches after superficial parotidectomy with small nodular mass in the masseter muscle.

Figure 2

(a,b) Tumor cells are arranged in sheets with interspersed foci of necrosis, congestion, haemorrhage, cystic degeneration and large blood vessels (H&E stain, 10× and 20× respectively). (c) Epithelioid to plump spindle shaped tumor cells having large, moderately pleomorphic round to ovoid nuclei, coarse chromatin, moderate to abundant eosinophilic cytoplasm with few mitotic figures and rich network of small caliber blood vessels are noted (H&E stain, 40×). (d) Immunohistochemistry shows nuclear positivity for FLI-1.