Asian Journal of Case Reports in Surgery

Aims: To report a rare case of angiosarcoma in young adult patient, the flow of diagnosis, and management of the case.

Case Description: We reported a 36-year-old male came to the Surgical Oncology Division, Department of Surgery, Dr. Moewardi Hospital Surakarta with a lump in the molar region of his right mandible. Intraoral examination revealed a reddish soft humped oval mass with a necrotic portion. Wide excision was performed with histopathological results indicating angiosarcoma and chemoradiotherapy was planned. The patient did not check up because of the Covid-19 pandemic until one month later as the mass grew back quickly and bled easily. The second-wide excision was performed, and the histopathological results of necrotic tissue fragments and extensive bleeding were obtained; pleomorphic spindle cells, low cytoplasm, crude chromatin, and mitotic nuclei tended to be an angiosarcoma confirmed by positive CD31 immunohistochemical result. One week after the second excision, the mass was found to regrow, and the patient had metastases to the lung and liver. The patient died within 3 months of the diagnosis.

Discussion: Intraoral angiosarcoma is extremely rare. Angiosarcoma is aggressive with frequent local recurrence and distant metastases. Its progression is influenced by several factors, including age.

Conclusion: Angiosarcoma is a rare tumor and has a high rate of progression at a young age. Angiosarcoma of the oral soft tissue is very rare. Early diagnosis and prompt and precise treatment are fundamental to increasing survival rates.