Stereotactic radiotherapy with CyberKnife for a large angiosarcoma of the maxillary sinus: A case report

Angiosarcomas are extremely rare vascular neoplasms. The overall prognosis of angiosarcoma is poor because it generally presents as an aggressive neoplasm with a propensity for local recurrence and early distant metastasis, even when multimodality therapy is provided. Because of this aggressive behavior, it has not been possible to identify the optimal treatment for angiosarcoma. The CyberKnife system is a robotic stereotactic radiosurgery/radiotherapy device that can deliver a high dose of radiation precisely and with minimal damage to the surrounding tissue. We present a case in which a favorable outcome was achieved after stereotactic radiotherapy using a CyberKnife for the treatment of a large angiosarcoma of the maxillary sinus. An 87-year-old woman was admitted to our department with swelling on her right cheek. Intraoral examination revealed a mass, which extended from the buccal vestibule to the edentulous alveolar process corresponding to the maxillary right premolar. The patient's history revealed that the swelling was associated with repeated spontaneous oral hemorrhage. We performed stereotactic radiotherapy using a CyberKnife. Follow-up imaging and clinical findings indicated that complete response was achieved. Throughout the 4 years of follow-up, there were no complications and no signs of recurrence or metastasis.