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Not a Cyst: When a Cyst Obscures a More Nefarious Process.

Jordan Pilkington1, Nicholas Zoumberos2, Nicholas Frederickson3

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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.

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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.