Cutaneous angiosarcoma clinically presenting as progressive solid facial edema in a 43-year-old male

Area of Science:

• Oncology
• Dermatology
• Pathology

Background:

• Cutaneous angiosarcoma of the head and neck is a rare, aggressive malignancy.
• Prognosis is linked to tumor size, resectability, and diagnostic stage.
• Typical presentations include erythematous to violaceous skin lesions.

Observation:

• A 43-year-old male presented with 11 months of progressive, solid facial and neck edema.
• Initial skin biopsies showed non-specific findings, mimicking rosacea or edema.
• Medical therapies were ineffective, prompting further investigation.

Findings:

• Repeat biopsies confirmed cutaneous angiosarcoma involving the dermis and sub-cutis.
• CT scans revealed metastatic disease to the lungs and T6 vertebra.
• Chemotherapy with paclitaxel achieved a partial response, improving eyelid function.

Implications:

• This case illustrates a rare presentation of cutaneous angiosarcoma as solid facial edema.
• Diverse clinical manifestations can delay diagnosis of this aggressive neoplasm.
• Highlights the need for thorough investigation of persistent, unexplained edema.