Key result
A 67-year-old female with scalp nodules histologically appearing as benign epithelioid hemangioma behaved clinically as malignant angiosarcoma and succumbed to widely metastatic disease.
Why the study?
Diagnosis of vascular neoplasms remains challenging due to overlapping clinical and histopathological features between benign and malignant lesions.
Case Report (n=1)
This case highlights the need to interpret histopathology of vascular neoplasms in the context of clinical observation, as the clinical course may not always match the biopsy.
In this report, we describe a case of a healthy 67-year-old female with rapidly growing red nodules on the scalp that demonstrated histological features of benign epithelioid hemangioma on multiple instances yet behaved clinically as a malignant angiosarcoma. Despite multiple rounds of resection, radiation, and chemotherapy, the patient ultimately succumbed from her widely metastatic disease. Diagnosis of vascular neoplasms, including the spectrum of low-grade epithelioid hemangioma, intermediate-grade epithelioid hemangioendothelioma, and high-grade angiosarcoma remains challenging due to overlapping clinical and histopathological features. This report is presented to highlight the need for clinicians to interpret histopathology, whether benign or malignant, in the context of clinical observation as the clinical course may not always match the biopsy.
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Daftary et al. (2023) conducted a case report in Malignant angiosarcoma masquerading as benign epithelioid hemangioma (n=1). Resection, radiation, and chemotherapy was evaluated on Clinical course and survival. A 67-year-old female with scalp nodules histologically appearing as benign epithelioid hemangioma behaved clinically as malignant angiosarcoma and succumbed to widely metastatic disease.
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