[The monthly interesting case - case no. 63]

Angiosarcomas are rare, aggressive tumors of vascular origin. They occur most often in areas of long term sun exposed skin in the elderly, in long standing lymphoedema or after radiation therapy. The prognosis is poor, radical surgery required, in addition radiation or chemo-therapy are considered to be therapeutical options. We report on a male patient, 70 years old with a slightly bleeding blueish tumor encompassing the complete nose. This patient treated with several antibiotics while continuous growth led to the described course. After 4 months a biopsy was taken revealing an angiosarcoma of the nose. Subsequently the patient was referred to our department and due to staging results a surgical therapy (ablatio nasi) followed. The final histological diagnosis was a low grade angiosarcoma of the cutaneous and subcutaneous tissue of the nose without infiltration of bone or cartilage, confirmed by immunohistological staining. Angiosarcomas of the head and neck region are extremely rare. Especially only few cases of nasal angiosarcoma infiltrating the complete nose are described in literature. Prognosis, therapy and differential diagnosis have to be discussed.