Epithelioid Angiosarcoma: Symptoms and Treatment

• Endothelial cells are the source of the malignant vascular tumor known as angiosarcoma (AS). Radiation therapy and chronic lymphedema are linked in some instances, while the exact etiology is unknown.

• Early lesions may be mistaken for a bruise or a benign vascular disorder, making the diagnosis of AS difficult to make. Any older patient who has a history of radiation therapy and/or chronic lymphedema and a new, vascular-looking lesion should have AS suspected.

• Excision with wide margins during surgery is the preferred course of action.

Symptoms of Cutaneous Angiosarcoma

Anywhere, including organ systems other than the skin, can develop angiosarcoma.

    Clinical Situations

Angiosarcoma of the skin commonly manifests in one of three clinical scenarios:

• Geriatric patients are most likely to have scale-face AS;
• Prior radiation therapy is a setting where radiation-associated AS can occur;
• Stewart-Treves syndrome (KS) associated with lymphedema manifests on the extremities of people with persistent lymphedema, such as in the arm following axillary lymph node dissection for breast cancer.

    Epithelioid Angiosarcoma Symptoms

• A macule or patch that resembles a bruise and is red or purple at first but eventually becomes larger is the early AS lesion. There is frequently an irregular border that blends into the nearby normal skin.
• Red, purple, or even skin-colored papules, nodules, and tumors may appear as the illness gets worse.
• AS lesions that have progressed typically bleed or ulcerate.

Diagnosis

•  A biopsy is required to confirm the diagnosis of angiosarcoma. The usual recommendation is for a big, deep punch or incisional biopsy that includes subcutaneous fat. 

• It must be remembered that because the vascular alterations in the shallow dermis may be mild, AS may be challenging or impossible to diagnose on superficial biopsies. A shave biopsy shouldn't be done if AS is a significant clinical concern.

Treatment

    Drug Therapy