title: Angiosarcoma of the Scalp: Metastatic Pulmonary Cystic Lesions Initially Misinterpreted as Benign Findings on 18F-FDG PET/CT.
abstract: Angiosarcomas are rare and only represent about 2% of all soft tissue sarcomas. They arise from vascular or lymphatic endothelial cells and are most commonly located in the heart, liver, breast, and skin. Cutaneous angiosarcoma of the scalp is highly malignant and with dismal prognosis. Reported five-year survival is <30%. The mainstay of treatment is surgical resection and adjuvant radiation therapy, but failure rates following local therapy are high. Cutaneous angiosarcoma of the scalp has a predilection for pulmonary metastases with a variety of morphologic patterns on imaging. Metastatic disease in terms of pulmonary thin-walled, cystic lesions, may not be hypermetabolic on (18)F-FDG PET and, as such, could be misinterpreted as benign findings. We present a case demonstrating the diagnostic uncertainty and delay in an elderly male with angiosarcoma of the scalp presenting with metastatic lung lesions following failure of local therapy.
authors.affiliation: Department of Clinical Physiology, Nuclear Medicine &amp; PET, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9-PET 3982, DK-2100 Copenhagen, Denmark. kim.francis.andersen.01@regionh.dk.
authors.forename: Kim Francis
authors.initials: KF
authors.lastname: Andersen
authors.affiliation: Department of Clinical Physiology, Nuclear Medicine &amp; PET, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9-PET 3982, DK-2100 Copenhagen, Denmark. Elisabeth.Albrecht-Beste@regionh.dk.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Albrecht-Beste
authors.affiliation: Department of Clinical Physiology, Nuclear Medicine &amp; PET, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9-PET 3982, DK-2100 Copenhagen, Denmark. anne.kiil.berthelsen@regionh.dk.
authors.forename: Anne Kiil
authors.initials: AK
authors.lastname: Berthelsen
authors.affiliation: Department of Clinical Physiology, Nuclear Medicine &amp; PET, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9-PET 3982, DK-2100 Copenhagen, Denmark. annika.loft.jakobsen@regionh.dk.
authors.forename: Annika
authors.initials: A
authors.lastname: Loft
keywords: FDG PET; angiosarcoma; pulmonary metastasis
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