Multifocal Cutaneous Angiosarcoma of the Lower Limbs Presenting With Severe Tumour-Related Haemorrhage: A Case Report

Cutaneous angiosarcoma (CAS) is a rare and highly aggressive vascular tumour of endothelial origin with a poor prognosis.It can present with atypical skin lesions, making early diagnosis challenging.We present a case of a man in his late 80s who presented with a two-year history of weight loss, fatigue, iron-deficiency anaemia, and persistently elevated inflammatory markers.He subsequently developed rapidly progressive, multifocal violaceous nodules affecting both lower limbs.Initial differential diagnoses included melanocytic and nodular vasculitis.Skin biopsy confirmed high-grade CAS.The lesions progressed to fungation with recurrent bleeding, resulting in severe symptomatic anaemia requiring repeated blood transfusions.Management was complicated by his background of a persistent endoleak after endovascular aneurysm repair (EVAR) of a large abdominal aortic aneurysm (AAA).This case highlights the importance of considering CAS in rapidly evolving, atypically located skin lesions.Early diagnosis and patient-centred multidisciplinary management are essential, particularly when advanced disease and significant comorbidities limit therapeutic options.