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

Introduction: Nevus lipomatosus superficialis is a rare benign hamartomatous skin lesion. It is classified into 2 types: solitary and multiple. Lesions consist of multiple, flesh-colored or yellow papules and/or nodules in a segmental pattern, with a linear, zosteriform, or along the lines of skin folds distribution. Surfaces are smooth, but may also have verrucous or cerebri-form appearance. Pathogenesis is unknown, but there is speculation that precursor cells around dermal blood vessels give rise to mature fat cells in a mosaic pattern. Incidence is presently unknown, but this is the first reported case in this institution. Histopathology reveals presence of aggregates of mature adipose tissue among the collagen bundles of the dermis. Case Summary: DF is a 14-year-old, Filipino, female, who consulted due to multiple, pedun-culated, soft papules over the right lower back, and extending to the right flank, with a clustered arrangement. There was no history of trauma or manipulation, nor was there pain, pruri-tus, or other associated symptoms. Past medical, family, and social history were non-contributory. Initial impression was acrochordon. Excision biopsy revealed mature adipose tissue in the dermis, which is diagnostic for nevus lipomatosus superficialis. Serial excision was done. Conclusion Excision is the treatment of choice. Other treatment options that can be ex-ploredare COz laser, cryotherapy, and intralesional injection of phosphatidylcholine, which yield promising results recommended by other studies. Dermatopathology plays a vital role in the diagnosis of this condition. A high index of suspicion, a good clinical eye, and dermatopa-thologic analysis are essential tools in clinching the diagnosis.
Nevus ; Adipose Tissue