A unique case of a non-radiation induced angiosarcoma of the parotid mimicking temporomandibular joint disease

Introduction: Temporomandibular disease (TMD) is a common yet not fully understood condition. Many patients with TMD present to oral and maxillofacial clinics, however it is important to have a differential diagnosis as symptoms of certain conditions are similar. We present a case where an angiosarcoma of the parotid was mistaken for TMD and was initially treated as such. It is to the authors’ knowledge, that this is the first reported case of an angiosarcoma of the parotid mimicking TMD.

Case Report: A 92 year old male patient was referred by his dentist to our maxillofacial unit under the routine pathway with the diagnosis of painful and clicking temporomandibular joint. The patient presented 5-6 weeks after referral complaining of the right jaw feeling dislocated. On clinical examination there was a swelling over the right parotid region which was ill defined and approximately 3cm in diameter. A non-contrast magnetic resonance imaging of the head and neck suggested a lymphoproliferative process and a core biopsy reported angiosarcoma with epithelioid morphology. The tumour had rapidly grown and the patient was put on supportive care.

Discussion: Despite TMD being a common presenting disease, it is important not to forget other differential diagnosis. A surgical sieve is required to rule out other possible conditions. Early correct diagnosis is crucial in conditions such as angiosarcomas.