Radiation Therapy for Maxillary Sinus Epithelioid Hemangioendothelioma: A Case Report and Literature Review.

Epithelioid hemangioendothelioma (EHE) is a rare vascular tumor arising from endothelial cells, with potential involvement of various anatomical sites. We report the case of a 37-year-old woman presenting with a locally advanced recurrence of maxillary sinus EHE. Due to the tumor's extent and anatomical constraints, complete surgical resection was not feasible. The patient was treated with intensity-modulated radiotherapy (IMRT), achieving a favorable clinical and radiological response. This case highlights the potential of IMRT as an effective therapeutic option for unresectable, locally advanced EHE, with acceptable acute toxicity. Systemic therapy may also be considered in aggressive forms to improve symptom control and progression-free survival (PFS). However, the optimal sequence between systemic treatment and radiotherapy remains unclear when surgery is not an option.