Key result
Gradual surgical excision followed by skin grafting was performed for a 59-year-old female with cutaneous angiosarcoma on the scalp, highlighting surgery as the preferred management.
Case Report (n=1)
Surgical excision is the preferred management for cutaneous angiosarcoma, though multimodality therapy may be required based on patient factors.
Adds limited case-level evidence for surgical excision in scalp angiosarcoma; leaves open optimal multimodality strategies.
INTRODUCTION: Angiosarcoma is a very rare malignancy, which varies based on the location and organ affected. A clinicopathological form of cutaneous angiosarcoma (CAS) involves the head: scalp, face, and neck. We report a 59-year-old female patient with CAS on the temporoparietal region of the scalp. CASE PRESENTATION: The patient presented with lesions in the head area, which appeared suddenly in the last 6 months, (before her surgery). Excision was performed under general anesthesia for bleeding as indicated on the right temporal region. The excision procedure was carried out three times at various stages, and then closed with skin grafts. Pathological examination of the three excised tissues showed progression, leading to CAS. Based on the clinical picture and anatomical assessment, a consultation with the surgical oncology department was necessary for further treatment. DISCUSSION: Angiosarcoma has a high rate of progression. The onset of lesions, which are difficult to detect, does not often lead to progression. Other macroscopic features appear as bluish macules, which can be perceived as bruising. Wide surgical resection is the optimal treatment and is usually combined with radiotherapy and/or chemotherapy. This patient underwent gradual excision, based on bleeding in the right temporal lesion, along with progressive pain. CONCLUSION: Surgical is the preferred management for our patients. Determination of multimodality therapy as treatment for CAS requires assessment of all factors related to age and patient condition. Follow-up evaluation is carried out after palliative therapy - to observe the general condition of the patient, tumor progression, tendency for metastases, and excision of any remaining lesions.
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Oley et al. (2021) conducted a case report in Cutaneous angiosarcoma (n=1). Surgical excision was evaluated. Gradual surgical excision followed by skin grafting was performed for a 59-year-old female with cutaneous angiosarcoma on the scalp, highlighting surgery as the preferred management.
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