Epithelioid angiosarcoma of the mons after chemoradiation for vulvar cancer

Angiosarcomas are rare malignant tumors of endothelial origin with morphological properties similar to the vascular and lymphatic endothelium. Associated risk factors include chronic lymph edema and previously irradiated areas. Our patient is the first case report of an angiosarcoma of the mons pubis after chemoradiation and the second reported angiosarcoma of the mons. She was a 74-year-old woman who initially presented with stage II keratinizing squamous cell carcinoma of the vulva that underwent neoadjuvant chemoradiation followed by a radical vulvectomy with bilateral inguinal-femoral lymphadenectomy. She presented 4 years later with a lesion on her mons, consistent with an angiosarcoma. Angiosarcomas are rare malignant tumors of endothelial origin with morphological properties similar to the vascular and lymphatic endothelium. Our patient is the first case report of an angiosarcoma of the mons pubis after chemoradiation for vulvar cancer and the second reported angiosarcoma of the mons. Time to presentation was approximately 4 years from the time of completion of chemoradiation. She recurred within 6 months of surgical resection and required a reexcision. She currently is undergoing systemic chemotherapy after being diagnosed with a metastatic pelvic lymph node. As the treatment of vulvar cancer evolves, and more radiation therapy is given, the incidence of angiosarcomas will rise, requiring better diagnostic and treatment protocols.