Two cases of cutaneous angiosarcoma on the scalp and face in the elderly

Abstract

Two cases of cutaneous angiosarcoma of the scalp and face in the elderly are reported. Case 1 was an 89 years old man with ulcerated edematous, erythematous plagues on the scalp and right face for 2 months. Dermatological examination showed that ulcerated edematous, erythematous patches on the crown, forehead, and right face, with unclear boundaries. The involved skin was tight, shiny, and depressed under pressure. Ulcers and scabs were present on the crown (sized 2 cm×3 cm) and frontotemporal region (sized 4 cm×6 cm). Histopathology showed necrosis and atypical cells arranged in luminal pattern around lesion in the dermis. Immunohistochemistry showed CD31 (+), CD34 (+), ERG (+), HHV8 focal weak positive, P53 mutation, Ki-67 (30% +), CK (-), and CEA (-). Diagnosis: angiosarcoma. The patient and his family refused further diagnosis and treatment, and the patient passed away. Case 2 was an 81 years old female with dark erythema on the right scalp and face for 2 months. Dermatological examination revealed purple patch covered with purple papules and nodules on the right scalp and face. Skin histopathology showed slight thickening of the spinous layers, diffuse proliferation of endothelial cells in the dermis, segmentation of collagen, and atypia. Fissures and vascular lumens containing erythrocytes were also observed in the dermis. Immunohistochemistry: CD31 (+), CD34 (+), D240(+), ERG(+), Ki-67(≈35%+), S100(-), HMB45(-), and CK(-). Diagnosis: angiosarcoma of the scalp and face. The patient was transferred to the oncology department for radiotherapy and chemotherapy, and passed away during follow-up.

Keywords

• angiosarcoma
• scalp and face