Clinicopathologic Study for 10 Cases of Cutaneous Angiosarcoma

Kim, Tae Wook; Mun, Je Ho; Jwa, Seung Wook; Song, Margaret; Ko, Hyun Chang; Kim, Byung Soo; Kim, Moon Bum; Kim, Hoon Soo

Abstract

BACKGROUND
Cutaneous angiosarcoma (CAS) is occasionally difficult to differentiate with other benign dermatoses, clinically, because of various clinical manifestations.
OBJECTIVE
The aim of this study is to examine the clinical and histopathologic findings of CAS, and investigate specific clinicopathologic features to aid in the early diagnosis.
METHODS
We reviewed photographs, medical records and biopsy specimen of 10 cases diagnosed as CAS for 5 years at our clinic.
RESULTS
The male and female numbers were 7 and 3, and the mean onset age was 69.7 years old. The mean duration of disease was 5.7 months. The site of involvement was scalp or face in all patients. The most common clinical feature was erythematous or purpuric nodule, with surrounding erythematous or purpuric patch, without symptoms. Initial impressions based on clinical findings on the first visit of our clinic were CAS (n=6), squamous cell carcinoma (n=2), basal cell carcinoma (n=1), and erysipelas (n=1). Histopathologically, irregular vascular channels lined by atypical endothelial cell dissect between the collagen bundles were seen in 6 cases, malignant endothelial cells forming continuous sheets with epithelioid morphology in 3 cases, and mild vascular hyperplasia in 1 case. CD31 was positive on atypical endothelial cells in all patients.
CONCLUSION
CAS should be included in differential diagnosis when cutaneous lesions show erythematous to purpuric nodule or patch with rapid progression on scalp or face of elderly patients. Histopathologically, CAS had wide spectrum from mild vascular hyperplasia to spindle cell tumors. As such, immunohistochemical stain, using endothelial markers, is valuable to diagnosis of CAS.