Angiosarcoma of the thyroid gland presenting initially with tonsillar metastasis - A case report and review of the literature

Angiosarcomas are rare, highly aggressive malignancies with a predilection for skin, soft tissue, and bone. Non-cutaneous angiosarcomas are exceptionally rare in the head and neck, including those of the thyroid gland. Metastatic behavior in later stages includes the lung, the skeleton/bone, and other sites such as the liver and the digestive system. A 56-year-old man presented with recurrent bleeding in the mouth (originating from the palatine tonsil) and pharynx and a growing goiter known of 30 years’ duration causing shortness of breath. Tonsillar biopsy revealed angiosarcoma. Imaging and biopsy evaluation of the thyroid gland confirmed the thyroid gland as the origin of his angiosarcoma. Due to its rarity, the metastatic behavior and therapy of thyroid angiosarcoma remain unclear. Physicians should consider the possibility of distant metastasis in patients with pharyngeal masses. The rarity of primary mucosal angiosarcomas of the head and neck should always warrant a search for another primary neoplasm in the head and neck or other sites.