MULTIPLE ANGIOSARCOMAS IN THE GINGIVA

Abstract

A 56-year-old white woman complained of "bleeding gum lesions." Previous medical history revealed systemic arterial hypertension, diabetes mellitus, cardiac arrhythmia, and surgery for a prosthetic heart valve placement. Oral examination showed 3 pedunculated nodules in the gingiva involving the 3 remaining upper teeth, about 1.5 cm in greatest diameter, with rapid growth and bleeding but otherwise asymptomatic. Diagnostic hypothesis was pyogenic granuloma. Complete blood count showed leukopenia and thrombocytopenia. Excisional biopsy of 1 of the nodules was performed with local hemostatics agents, after medical consultation. Histopathologic analysis was suggestive of malignant mesenchymal neoplasm with histogenesis to be elucidated. Immunohistochemical study was positive for CD31 and negative for human herpesvirus 8 (HHV-8), S-100, p63, and AE1/AE3. The final diagnosis was angiosarcoma. During the investigation process, the patient experienced significant bone pain and worsening of her general condition, resulting in an emergency hospitalization. Ultimately, the patient succumbed to her condition while hospitalized. A 56-year-old white woman complained of "bleeding gum lesions." Previous medical history revealed systemic arterial hypertension, diabetes mellitus, cardiac arrhythmia, and surgery for a prosthetic heart valve placement. Oral examination showed 3 pedunculated nodules in the gingiva involving the 3 remaining upper teeth, about 1.5 cm in greatest diameter, with rapid growth and bleeding but otherwise asymptomatic. Diagnostic hypothesis was pyogenic granuloma. Complete blood count showed leukopenia and thrombocytopenia. Excisional biopsy of 1 of the nodules was performed with local hemostatics agents, after medical consultation. Histopathologic analysis was suggestive of malignant mesenchymal neoplasm with histogenesis to be elucidated. Immunohistochemical study was positive for CD31 and negative for human herpesvirus 8 (HHV-8), S-100, p63, and AE1/AE3. The final diagnosis was angiosarcoma. During the investigation process, the patient experienced significant bone pain and worsening of her general condition, resulting in an emergency hospitalization. Ultimately, the patient succumbed to her condition while hospitalized.