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Not a Cyst: When a Cyst Obscures a More Nefarious Process.
Jordan Pilkington1, Nicholas Zoumberos2, Nicholas Frederickson3
1Departments of Pathology and Dermatology, University of Arkansas for Medical Sciences, Little Rock, AR.
The American Journal of Dermatopathology
|May 2, 2025
Summary
Angiosarcoma, a rare vascular tumor, can be missed when co-occurring with cysts or follicles. Careful slide review is crucial for diagnosing this aggressive malignancy, especially in elderly patients with sun-damaged skin.
Area of Science:
- Oncology
- Pathology
- Dermatology
Background:
- Angiosarcoma is an aggressive malignancy originating from endothelial cells.
- It commonly affects sun-damaged skin on the head and neck in elderly individuals.
- Diagnosis can be challenging due to potential co-existing benign findings.
Purpose of the Study:
- To highlight the diagnostic challenges of angiosarcoma.
- To emphasize the importance of thorough histopathological evaluation.
- To present cases where angiosarcoma was obscured by ruptured cysts or follicles.
Main Methods:
- Case report presentation.
- Histopathological slide review.
- Differential diagnosis consideration.
Main Results:
- Two cases of angiosarcoma are presented.
- The angiosarcoma diagnosis was initially obscured by associated ruptured cysts or follicles.
- Careful examination revealed the underlying malignancy.
Conclusions:
- Ruptured cysts or follicles can mimic or mask angiosarcoma.
- Thorough evaluation of all histological features is essential.
- Avoiding diagnostic pitfalls requires vigilance for subtle background malignancies.
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