Cutaneous angiosarcoma complicating morbid obesity.
Herein, we report a case of cutaneous angiosarcoma in a 35-year-old, morbidly obese woman. The tumor arose in the most dependent portion of the lower abdominal panniculus and showed typical changes of chronic lymphedema. The patient underwent a radical resection of her lower abdominal wall panniculus, which showed a multicentric, high-grade angiosarcoma with bilateral superficial inguinal lymph node metastases. Histologically, conventional vasoformative areas were admixed with poorly differentiated sheets of spindle and epithelioid cells. Factor VIII was focally positive (membranous), whereas CD31 showed robust, diffuse positivity (membranous and cytoplasmic). The initial margins of resection were negative, and no follow-up radiation or chemotherapy was given. Following a recurrence at the previous excision site, the patient died 7 months after the surgery. Postmortem examination revealed a widely metastatic tumor that involved multiple organ systems. We believe this is the second report of cutaneous angiosarcoma occurring in a chronically lymphedematous abdominal panniculus due to morbid obesity.
Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
M
M
Azam
H
H
Saboorian
S
S
Bieligk
T
T
Smith
K
K
Molberg
D000328:Adult; D002908:Chronic Disease; D005169:Factor VIII / Q000032:analysis; D017809:Fatal Outcome; D005260:Female; D006394:Hemangiosarcoma / Q000737:chemistry / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008209:Lymphedema / Q000209:etiology* / Q000473:pathology; D009364:Neoplasm Recurrence, Local; D009767:Obesity, Morbid / Q000150:complications* / Q000473:pathology; D019408:Platelet Endothelial Cell Adhesion Molecule-1 / Q000032:analysis; D012878:Skin Neoplasms / Q000737:chemistry / Q000209:etiology* / Q000473:pathology / Q000601:surgery
D019408:Platelet Endothelial Cell Adhesion Molecule-1; D005169:Factor VIII