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Dermatology
Recognising angiosarcoma presenting as an enlarging ecchymotic plaque
  1. Michelle Wu1,
  2. Theone Papps2,3 and
  3. Bruno Blaya-Alvarez1,2
  1. 1 Department of Dermatology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
  2. 2 The Skin Hospital, Darlinghurst, New South Wales, Australia
  3. 3 Department of Dermatology, Royal North Shore Hospital, St Leonards, New South Wales, Australia
  1. Correspondence to Dr Michelle Wu; michelle.wu{at}health.nsw.gov.au

Abstract

Cutaneous angiosarcoma (cAS) is a rare malignant neoplasm of vascular endothelial origin with an unfavourable prognosis. Its diagnosis often faces delays due to its manifestation as an inconspicuous ‘bruise-like’ lesion in an otherwise asymptomatic individual, leading to a generally low index of suspicion for angiosarcoma. Here, we present a case of a man who presented to his general practitioner with an ecchymotic plaque on his forehead, initially thought to be benign. Over the subsequent 6 weeks, the lesion progressively enlarged and became ulcerated, prompting the patient to represent to his general practitioner. He was urgently referred to a dermatologist and a subsequent biopsy confirmed the diagnosis of cAS. Our presentation of this case serves as a reminder for physicians to maintain a high index of suspicion and low threshold for biopsy for patients with atraumatic ecchymotic lesions.

  • Dermatology
  • Skin cancer

https://doi.org/10.1136/bcr-2023-258751

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    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content: MW. The following authors gave final approval of the manuscript: BB-A and TP.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.