Unusual Clinical Presentation of Cutaneous Angiosarcoma Masquerading as Eczema: A Case Report and Review of the Literature

Abstract

An unusual case of cutaneous angiosarcoma clinically mimicking eczema is described. A 98-year-old Caucasian male presented with a 6-month history of a flesh-colored, subcutaneous nodule on his left forehead with contralateral facial erythema and scaling that had been previously diagnosed as eczema. Despite treatments with topical steroids and moisturizers, the condition did not resolve. At our clinic, excisional biopsy of the forehead lesion and scouting biopsies from the contralateral cheek were performed which revealed cutaneous angiosarcoma. The described case illustrates that dermatitis-like features should be considered as a rare clinical manifestation of cutaneous angiosarcoma. It also demonstrates that these lesions may respond well to radiotherapy as a single modality.

Cutaneous Angiosarcoma of the Foot: A Case Report and Review of the Literature

“…As regards clinical appearance, the appearance of cutaneous angiosarcoma can be variable [ 4 ] and it can manifest as bruise-like lesions [ 8 ], raised purplish-red papules [ 9 ], and rosacea-like lesions [ 10 ]. Due to the variability in the appearance of cutaneous angiosarcoma, the correct diagnosis can often be delayed.…”

“…Due to the variability in the appearance of cutaneous angiosarcoma, the correct diagnosis can often be delayed. Differential diagnoses include, but are not limited to, eczema [ 4 ], Kaposi sarcoma [ 11 ], scarring alopecia [ 12 ], sebaceous cysts [ 13 ], and amelanotic melanoma [ 14 ]. Our case is unique that it presented with cutaneous ulceration.…”

“…Angiosarcoma is a rare, malignant neoplasm comprising 1–3% of adult soft tissue sarcomas [ 1 – 4 ]. This is typically a tumor of older individuals with a median age of 70–75 years and a male predominance, having a predilection for the scalp and central area of the face.…”

“…The neoplasm tends to invade tissue more widely than is clinically apparent and is thus prone to incomplete excision. Majority of patients present with locally advanced disease, regional lymph node involvement, or distant metastases at the time of initial diagnosis, all of which are associated with a poor prognosis [ 4 ]. The present study describes a case of cutaneous angiosarcoma of the foot in the setting of chronic lymphedema which was treated with definitive radiation alone.…”

Clinicopathological and survival analyses of primary cutaneous angiosarcoma in an Asian population: prognostic value of the clinical features of skin lesions

“…The clinical presentation of CA varies from ill‐defined bruise‐like lesions to multifocal indurated plaques and nodules . CA may also resemble rosacea, eczema, xanthelasma, cellulitis, and angioedema . Histopathologically, CA has considerable variability, ranging from well‐differentiated vascular tumors similar to various benign vascular proliferations to epithelioid tumors, which sometimes mimic a nonvascular tumor such as carcinoma .…”