Intraparotid lymph node with metastatic angiosarcoma: A rare tumor with a routine presentation

Introduction: We present an unusual case presenting as a parotid tumor in a Caucasian man, including our management and a review of literature. Case Report: A 83­year­old male was referred to the ENT department with a non­ painful swelling in front of his right ear. This was diagnosed as a likely Warthin’s tumor and this was further supported by ultrasound imaging. Fine needle aspiration cytology was non­diagnostic. The patient underwent superficial parotidectomy for histological confirmation. Histology identified an intraparotid lymph node with metastatic angiosarcoma. The primary source was not identified. The patient was further treated with adjuvant radiotherapy and at a 10­month post­ therapy review there is no evidence of reoccurrence. Conclusion: An angiosarcoma is a rare malignant neoplasm of endothelial­type that is characterized by rapidly proliferating and infiltrating anaplastic cells. Angiosarcoma’s account for less than 0.1% of all head and neck cancers and it is extremely rare for the major salivary glands to be affected; 80% of all parotid tumors are benign. Metastatic angiosarcoma arising in an intraparotid lymph node has not previously been reported in English journals. This presented case is unusual in its location and its mode of presentation.