Multifocal Angiosarcoma of the Scalp: Review of the Literature and Report of Two Cases

Abstract

Cutaneous angiosarcoma of the head and neck is a rare disease with a very difficult treatment. We report two cases of patients with cutaneous angiosarcoma of the scalp and a review of the literature. Both patients were female and their average age was 70.3 years. In the two cases, the clinical presentation of the angiosarcoma was a multifocal tumor of the scalp with bleeding and ulceration. One of the patients had regional lymph node metastasis and the other had lung metastasis. Both lesions received surgical treatment with wide excision and were reconstructed immediately; negative margins were reported in the definitive section. One patient underwent a posterolateral neck dissection. Cutaneous angiosarcoma of the scalp is an aggressive tumor that has a high metastatic potential; its treatment consists of a wide surgical resection with negative margins and radiation therapy; despite this, its prognosis is generally poor.

Introduction

Soft tissue sarcomas are rare and aggressive tumors, which in the head and neck area account for 1%. Angiosarcomas represent less than 1% of all sarcomas; being most frequent in head and neck region, and especially in the scalp [1-3]. Mainly, treatment of this tumor is usually wide excision with reconstruction, whenever possible, followed by radiation therapy. In cases of extensive or unresectable tumors, chemotherapy and radiation therapy could be used. We present two cases of angiosarcomas of the scalp that developed as multifocal lesions. Both were treated with wide excision with reconstruction.

Discussion

Head and neck sarcomas are infrequent, being angiosarcomas 10% of them. Angiosarcoma is a malignant tumor of vascular endothelial cells that can arise in any location of the body. In contrast to the deep location of most soft tissue sarcomas, angiosarcomas have a predilection for the skin and superficial soft tissue. Therefore, it is not uncommon to find them in the face and scalp.

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Mary Wilson
Journal Manager
Journal of Tumor Research
Email: tumour@medicalresjournals.com