title: Infraorbital cutaneous angiosarcoma: a diagnostic and therapeutic dilemma.
abstract: BACKGROUND
  A cutaneous angiosarcoma is a rare malignant tumour of vascular endothelial cells with aggressive clinical behaviour and poor prognosis. Diagnosis is often delayed due to its variable and often benign clinical appearance.
  
  
  METHODS
  This case presents a 64-year-old man with a six-month-history of a recurrent diffuse and erythematous painless swelling below the left eye. Several resections with intraoperatively negative resection margins followed, but positive margins were repeatedly detected later on permanent sections. Histopathologic examination of the specimen diagnosed a cutaneous angiosarcoma. Neither, finally achieved negative margins on permanent sections, nor a following chemotherapy could prevent the recurrence of the disease after five months and the patient's dead 21 months after the first diagnosis.
  
  
  CONCLUSIONS
  The case elucidates the current diagnostic and therapeutic dilemma of this entity, which shows an unfavourable clinical course in spite of multimodal therapy.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Muenster University, Germany. Johannes.Kleinheinz@ukmuenster.de
authors.forename: Tobias
authors.initials: T
authors.lastname: Ettl
authors.forename: Johannes
authors.initials: J
authors.lastname: Kleinheinz
authors.forename: Ravi
authors.initials: R
authors.lastname: Mehrotra
authors.forename: Stephan
authors.initials: S
authors.lastname: Schwarz
authors.forename: Torsten E
authors.initials: TE
authors.lastname: Reichert
authors.forename: Oliver
authors.initials: O
authors.lastname: Driemel
mesh_terms: D001707:Biopsy, Needle; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D018450:Disease Progression; D005153:Facial Neoplasms / Q000473:pathology* / Q000628:therapy; D017809:Fatal Outcome; D006394:Hemangiosarcoma / Q000473:pathology* / Q000628:therapy; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000628:therapy; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant; D012086:Reoperation; D012878:Skin Neoplasms / Q000473:pathology* / Q000628:therapy