Angiosarcoma is a rare and highly aggressive soft tissue sarcoma arising from endothelial cells. It most commonly arises from the skin of the head and neck. The etiology of angiosarcoma is unknown but associated factors include chronic lymphedema, radiation, and exposure to environmental carcinogens.

An 83-year-old Filipino male presented initially with an erythematous patch on the left cheek. Over the course of 2 months, he had two different otorhinolaryngology consults and underwent courses of oral antibiotics with no relief. The lesion evolved into an indurated and ulcerated plaque involving the left cheek, eyelid, and medial face. Subsequent Rheumatology consult resulted in autoimmune laboratory tests being requested which all turned out to be normal. Finally, upon referral to Dermatology, a wedge skin biopsy was done. Histopathologic findings were suspicious for angiosarcoma. The specimen stained positive with CD31, and this confirmed the diagnosis. The patient was referred to Medical Oncology for further evaluation and management. The patient exhibited reluctance to undergo additional diagnostic procedures, hospital admission, and treatment. Progressive tumor enlargement led to its associated complications including nasal airway obstruction. The patient died in the course of 3 months after definitive diagnosis.

The clinical presentation of cutaneous angiosarcoma is nonspecific, often starting as a bruise-like patch. Diagnosis relies heavily on a high index of suspicion and histopathology. It is important to catch angiosarcoma early to offer a better prognosis for the patient. This case highlights the role of Dermatologists in a multi-specialty team approach setting.