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Back-to-basics of hemangiosarcoma of face and scalp: a case report


Journal of Dermatology & Cosmetology
Bruno de Oliveira Rocha,1 Érica Sales Souza,1 Leonardo Lordello,2 Vitória Regina Pedreira de Almeida Rêgo,1 Maria de Fátima Santos Paim de Oliveira1

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Abstract

Hemangiosarcoma is a rare vascular malignant neoplasm. Diagnosis is based on both clinical and histopathological features. Case Presentation: An 85-years-old white man presented with a 1-year history of progressive lesions on face and scalp. Physical examination revealed violaceous infiltrative plaques, with ulceration and bleeding, on the face and scalp, associated to numerous violaceous satellites papules. Histopathological examination revealed a neoplastic proliferation represented by slit-like anastomosing vascular channels that dissociated collagen fibers in the dermis, lined by atypical endothelium with moderately hyperchromatic and pleomorphic nuclei. Diagnostic conclusion was cutaneous angiosarcoma. Conclusions: Cutaneous angiosarcoma most often affects males (2:1), mostly Caucasian patients over 70 years old. It may originate from blood or lymphatic vessels. The most common form affects the face and scalp. There are varying degrees of cellular atypia, anastomosing slit-like channels, dissociation of collagen fibers, occasional hyaline globules and areas of hemorrhage. Immunohistochemistry confirmed blood vascular origin with diffuse positivity for CD34 and focally diffuse for factor VIII. We emphasize the need of clinicopathological correlation for early recognition and treatment

Keywords

cutaneous angiosarcoma, hemangiosarcoma, violaceous infiltrative, hyaline globules cytopathologic examination, tumor, invasion, needle aspiration

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