Angiosarcoma: clinical and histopathological characterization of five cases and literature review

Mélissa M. de Carvalho, Department of Dermatology and Venereology, Unidade Local de Saúde de Lisboa Ocidental, Lisbon, Portugal Margarida M. Valejo-Coelho, Department of Dermatology and Venereology, Unidade Local de Saúde de Lisboa Ocidental, Lisbon, Portugal Ana Gusmão-Palmeiro, Department of Dermatology and Venereology, Unidade Local de Saúde de Lisboa Ocidental, Lisbon, Portugal Isabel Viana, Department of Dermatology and Venereology, Unidade Local de Saúde de Lisboa Ocidental, Lisbon, Portugal Rui Bajanca, Serviço de Dermatologia, Hospital de Egas Moniz, Unidade Local de Saúde de Lisboa Ocidental, Lisbon, Portugal

Angiosarcomas are rare, aggressive endothelial tumors, accounting for < 1% of all sarcomas. These tumors predominantly affect elderly Caucasian men and often occur on the face, scalp, or in areas of chronic lymphedema or previous radiotherapy exposure. Early diagnosis is essential due to their high recurrence and metastasis rates. This study aims to describe and analyze five cases of cutaneous angiosarcoma diagnosed at a tertiary hospital in Lisbon, highlighting clinical presentations and the importance of timely diagnosis. We reviewed five cases of cutaneous angiosarcoma diagnosed between 2014 and 2023 at a tertiary hospital. Data on demographics, clinical presentation, and tumor location were retrospectively collected and analyzed. The sample included five patients: three females and two males, with a mean age of 75.8 years. Lesions presented as erythematous and violaceous patches, plaques, and nodules across various anatomical sites. The findings emphasize the diversity of clinical presentations and underscore the need for a high index of suspicion among dermatologists. Due to the aggressive nature of angiosarcomas, dermatologists must maintain a high level of suspicion for early diagnosis, which can improve outcomes. In addition, there is an urgent need to develop novel therapeutic strategies to manage these tumors effectively.

Keywords: Cutaneous angiosarcomas. Endothelial tumors. Sarcomas.