Mimickers of Malignancy – Epithelial Tumors Mimicking Angiosarcoma: A Case Series

Authors: Katrina Erika R. Habaluyas, MD-MBA, Cynthia Ciriaco-Tan, MD, FPDS

Abstract

Introduction: Angiosarcoma is a rare aggressive malignant tumor of endothelial cell origin, with a predilection for the skin and superficial soft tissues (50% affecting the head and neck). Early diagnosis is imperative to facilitate proper management and increase overall survival rate, given its high rate of metastasis.

Case Summary: We report 2 cases of angiosarcoma with varied presentations. Case 1 is a 71-year old with a 7-month history of an initially asymptomatic solitary erythematous, pimple-like papule on the scalp, which progressed into a non-healing wound with no response to topical and oral antibiotics. Significant left eye swelling was also reported. Case 2 is a 79-year old with a 9-month history of a solitary erythematous nodule on the scalp, which progressed into dusky red to violaceous patches and plaques. Both cases underwent skin punch biopsy and presented with characteristic histopathologic features of a Vascular Neoplasm. Special stains were requested which confirmed the diagnosis of Angiosarcoma. Both cases were referred for radiation therapy with noted significant reduction in both size and erythema of the lesions after a few sessions.

Conclusion: Angiosarcoma is a rare, malignant tumor that can have varied presentations that can be easily mistaken for an epithelial tumor such as Squamous cell carcinoma or Melanoma. A comprehensive history and a complete physical examination (assessment of swelling, lymphedema, or involvement of lymph nodes) are warranted to facilitate early diagnosis. An index of suspicion of angiosarcoma should warrant a skin punch biopsy with routine hemotoxylin and eosin and confirmed with at least CD31 and/or CD34.

 

Citation

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Keywords

angiosarcoma, vascular neoplasm, epithelial tumors

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