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Angiosarcoma of the skin

Angiosarcoma of the skin. Deba P Sarma, MD Omaha. F 58, right retroauricular scalp. Ulcerated, purple-blue mass behind the right ear. Dermal neoplasm composed of infiltrating irregular, vascular or sinusoidal anastomosing channels.

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Angiosarcoma of the skin

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  1. Angiosarcoma of the skin Deba P Sarma, MD Omaha

  2. F 58, right retroauricular scalp Ulcerated, purple-blue mass behind the right ear

  3. Dermal neoplasm composed of infiltrating irregular, vascular or sinusoidal anastomosing channels

  4. Vessels are lined by a disorganized proliferation of polyhedral atypical endothelial cells with scant amphophilic cytoplasm, and dark blue nuclei. Micropapillae of the neoplastic cells with a hobnail appearance are seen projecting into the lumen of the neoplastic vessels.

  5. CD 34: Positive

  6. Factor VIII: Positive

  7. Ki 67: High proliferative activity

  8. Diagnosis: Angiosarcoma • Cutaneous angiosarcoma primarily affects elderly patients and is commonly located on the head and neck, especially the scalp. Microscopically, the classic angiosarcoma is composed of a disorganized vascular or sinusoidal anastomosing network with infiltration into the dermis; the neoplastic slit-like vessels dissect the dermal collagen. The tumor cells are polyhedral, atypical endothelial cells with a high nucleus to cytoplasm ratio and scant amphophilic cytoplasm. Angiosarcoma may also have other histological variants that include the spindle type, solid epithelioid type, hemangioma-like type, granular cell variant, and pleomorphic type

  9. The prognosis for patients with angiosarcomas of the scalp is poor because these tumors recur and metastasize by lymphatic or hematogenous routes. In our case, the patient died soon after diagnosis with metastasis. Ref: Angiosarcoma of the scalp mimicking a sebaceous cyst Zenggang Pan MD PhD1, Daniel Albertson MD1, Amardip Bhuller MD2, Bo Wang MD1, James M Shehan MD3, Deba P Sarma MD1 Dermatology Online Journal 14 (6): 13 1. Department of Pathology, Creighton University Medical Center, Omaha, Nebraska. bowang@creighton.edu2. Department of Surgery, Creighton University Medical Center, Omaha, Nebraska3. Department of Medicine, Division of Dermatology, Creighton University Medical Center, Omaha, Nebraska

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