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Angiosarcoma of the skinAngiosarcoma of the skin

Deba P Sarma, MDDeba P Sarma, MD

OmahaOmaha

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F 58, right retroauricularF 58, right retroauricularscalpscalp

Ulcerated, purple-blue

mass behind the right ear

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Dermal neoplasm composed of infiltrating irregular,

vascular or sinusoidal anastomosing channels

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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.

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CD 34: Positive

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FactorVIII: Positive

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Diagnosis: AngiosarcomaDiagnosis: Angiosarcoma

Cutaneous angiosarcoma primarily affects elderly patientsCutaneous angiosarcoma primarily affects elderly patientsand is commonly located on the head and neck, especiallyand is commonly located on the head and neck, especiallythe scalp.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 cellvariant, and pleomorphic type

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The prognosis for patients with angiosarcomas of the scalp is poorbecause 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.edu

2. Department of Surgery, Creighton University Medical Center, Omaha,

Nebraska

3. Department of Medicine, Division of Dermatology, Creighton University

Medical Center, Omaha, Nebraska