Which physical findings are characteristic of angiosarcoma of the scalp?

Updated: Jan 03, 2020
  • Author: Jonathan S Zager, MD, FACS; Chief Editor: Gregory Gary Caputy, MD, PhD, FICS  more...
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Answer

Most cutaneous angiosarcoma appears on the scalp or upper forehead. Angiosarcoma of the face and scalp is insidious, and its clinical manifestations vary widely. In the early stages, angiosarcoma of the face and scalp frequently appears clinically innocent. The lesions may be single or multifocal; bluish or violaceous; nodules, plaques, or flat infiltrating areas; and occasionally may bleed or ulcerate. Most early lesions begin as ill-defined, bruiselike areas with an indurated border. More advanced lesions can be elevated, nodular, or occasionally ulcerated. Grossly, the tumors may appear as ill-defined, hemorrhagic areas.

Extensive local growth is common, and margins are difficult to define surgically. Multifocality is noted in approximately half the patients. Metastasis to regional lymph nodes and to the lungs can occur, often after repeated surgical excisions of the primary growth. In these patients, the prognosis is poor. As reported by Weedon and Freedman, this may reflect the fact that clinical diagnosis is often delayed until the lesions are advanced. [11] Still, even very small tumors can extend microscopically far beyond the visible boundaries of the lesion.


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