Epithelioid angiosarcoma of the oral cavity: a histopathological and immunohistochemical diagnostic conundrum

Epithelioid angiosarcoma is a rare and aggressive malignant neoplasm of endothelial origin, with limited cases reported in the oral cavity. Its clinical and histopathological features often mimic benign and malignant vascular lesions, posing a diagnostic challenge. The current case report is of a 42 year old male, who presented with a sessile granular growth with ulcerated surface on the palatal gingiva of one year duration. A thorough histopathological evaluation of the biopsy specimen revealed multiple layers of endothelial cells around vascular channels and epithelioid tumour cells arranged in clusters containing tiny slits filled with RBC, cellular and nuclear pleomorphism and a high Ki-67 index of 50.6 %. The current case emphasizes the importance of performing a biopsy on long standing indolent lesions as well as highlights the ease of diagnosing a rare intraoral malignancy with the aid of histopathology and immunohistochemistry.