Introduction: Angiosarcoma is a rare head and neck sarcoma of vascular endothelial cell origin. We report a case of angiosar- coma in an elderly male, and the multidisciplinary approach employed in his treatment. Case report: A 79-year-old male presented with a 4-month history of a rapidly enlarging black, soft, immovable tumor surround- ed by bruise-like patches over the right temporoparietal scalp. There was associated pruritus and bleeding when scratched. Dermoscopy showed bluish black crusts over the tumor, and surrounding violaceous patches. Wedge biopsy revealed a dermis with irregular vascular spaces infiltrating dermis, lined by atypical endothelial cells. Immunohistochemistry of the atypical in- filtrative cells was positive for CD31. These findings were consistent with angiosarcoma. The patient underwent wide excision with a rotational flap and split thickness skin graft. Postoperatively, the patient was referred to Oncology for adjuvant radiation therapy. Conclusion Even with treatment, the prognosis of angiosarcoma remains poor due to its aggressive nature, with a 5-year sur- vival rate ranging from 10-54%. However, early detection of the disease may increase patient survival rates. This rare case shows the importance of maintaining a high level of suspicion for lesions that have an atypical presentation to prevent delays in man- agement and improve patient outcomes.
Hemangiosarcoma ; Scalp ; Neoplasms