An unusual manifestation of cutaneous angiosarcoma: a case report of a rare tumor

Cutaneous angiosarcoma is a rare tumor of the head and neck region, most commonly affecting the elderly male. Its presentation varies from a small plaque to multifocal nodules. Differentiating this tumor from other conditions, such as hemangiomas, Kaposi sarcoma, squamous cell carcinoma, and rosacea, is sometimes difficult. Herein, we present a case of a 73-year-old male with a small oozing lesion on the scalp for more than two months. He had a history of scalp irradiation for tinea capitis in his childhood. Also, he experienced multiple basal cell carcinomas on his scalp a few years ago. Skin biopsy revealed infiltrations of malignant neoplastic lesions composed of proliferated pleomorphic tumoral cells with hyperchromatic nuclei and some epithelioid features arranged as sheets and irregularly shaped vascular spaces mostly devoid of red blood cells. Neoplastic cells were diffuse and strongly positive for D2-40, CD31, CD34, and Ki67 but negative for C-myc and CK. Cutaneous angiosarcoma should be considered in the differential diagnoses of scalp lesions, particularly in older men.