Concerned about the possibility of some type of cancer, the FP did a 3-mm punch biopsy, which revealed that this was an angiosarcoma.
Cutaneous angiosarcomas are rare malignant vascular tumors most commonly found on the head and neck of elderly men, and thought to arise from vascular endothelium. Elevation of several growth factors and cytokines has been associated with this malignancy. Skin biopsy of cutaneous angiosarcoma reveals irregular vascular channels and atypical endothelial cells.
Cutaneous angiosarcoma is best treated with excision and wide surgical margins, as the primary tumor is often more extensive than appears on exam. Postoperative radiotherapy is then used at the primary site and regional lymphatics. If inoperable, palliative chemotherapy may be considered. In this case, the patient was referred to a head and neck surgeon.
Text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. Photo courtesy of Amor Khachemoune, MD. This case was adapted from: Hitzeman N. Acquired vascular lesions in adults. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. The Color Atlas of Family Medicine. New York, NY: McGraw-Hill; 2009:861-864.
To learn more about The Color Atlas of Family Medicine, see:
• http://www.amazon.com/Color-Atlas-Family-Medicine/dp/0071474641
You can now get The Color Atlas of Family Medicine as an app for mobile devices including the iPhone and iPad by clicking this link: