Primary Cutaneous Angiosarcoma - Scalp

Dr. Sminu Mary John, Dr. U Prasanth

Abstract: This case report presents a comprehensive assessment of an 84-year-old female with an ulcero-proliferative scalp lesion, initially suspected to be either Squamous Cell Carcinoma or Amelanotic Melanoma. Radiological investigations revealed extra cranial soft tissue lesions. Histopathological examination following wedge biopsy disclosed features consistent with Primary Cutaneous Angiosarcoma, including a proliferating neoplasm of the dermis characterized by irregular anastomosing vascular channels, solid areas containing spindle cells arranged in fascicles, focal myxoid changes in the stroma, large epithelioid cells with ovoid vesicular nuclei, extensive haemorrhage, and necrosis. Immunohistochemical analysis demonstrated positivity for CD31 and Vimentin, supporting the diagnosis. This case underscores the diagnostic challenges associated with cutaneous lesions in elderly patients and highlights the importance of a multidisciplinary approach integrating clinical, radiological, and histopathological assessments for accurate diagnosis and optimal management.

Keywords: Angiosarcoma; Cutaneous angiosarcoma; Scalp; CD31 Antigen; Vimentin