Infraorbital cutaneous angiosarcoma: a diagnostic and therapeutic dilemma.
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.
Ettl
Tobias
T
Department of Oral and Maxillofacial Surgery, Muenster University, Germany. Johannes.Kleinheinz@ukmuenster.de
Kleinheinz
Johannes
J
Mehrotra
Ravi
R
Schwarz
Stephan
S
Reichert
Torsten E
TE
Driemel
Oliver
O
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