Clinical cases

Cutaneous angiosarcoma affecting primarily the scalp is a rare malignant tumor, very aggressive, with poor prognosis, which occurs more frequently in elder men.

We present the case of a 61 years old man diagnosed with angiosarcoma of the scalp, stage T2bN0M0, with the expression of Ki-67 protein in 40% of the tumor cells, for whom surgical excision of the lesions and radiotherapy was recommended.

Angiosarcoma's etiology is not fully understood, but risk factors such as radiation, chronic lymphedema, exogenous toxins have an important role. Clinically, it may have multiple forms, from papules to purple nodules, therefore histopathological and immunohistochemical examinations are imposed for an appropriate diagnosis.

Literature data showed that patients with strong expression of Ki-67 had the most unfavorable evolutions.
Because angiosarcoma is a very aggressive tumor, a rapid diagnosis and a curative surgical treatment followed by radiotherapy and/or chemotherapy is required.

Chemotherapy is the first indication for metastatic angiosarcoma. New antiangiogenetic drugs are tested in clinical trials.