title: Early Angiosarcoma of the Scalp: A Clinicopathological Pitfall.
abstract: Angiosarcoma (AS) is a rare malignant vascular tumor, which affects mainly elderly patients. After the diagnosis, the mean overall survival of patients is 30 months. The variable presentation of the malignancy, the benign appearance of the cutaneous lesions, and the minimal histological changes in early lesions can sometimes delay the correct diagnosis. The authors report a case of an 80-year-old white male patient, with a painless and ecchymotic lesion of the scalp, which histologically showed minimal pathological atypia, conclusive for a diagnosis of AS with minimal histological changes. The authors discuss the main and most emblematic cases of AS initially misdiagnosed for other cutaneous diseases reported in the literature, noting that in some cases, also the histology can be treacherous and a trap for the dermatopathologist. The recent findings on MYC, FLT4 and KDR amplification, and the relative therapeutic perspectives are also discussed. Finally, the authors draw up some pathological cornerstones, which could improve the diagnosis, above all in early lesions with minimal atypia.
authors.affiliation: *Clinica Dermatologica, La Sapienza University of Rome, Rome, Italy; †Clinical Department, San Gallicano Institute of Rome, Rome, Italy; and ‡Dermatopathological Laboratory, San Gallicano Institute of Rome, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Paolino
authors.forename: Viviana
authors.initials: V
authors.lastname: Lora
authors.forename: Carlo
authors.initials: C
authors.lastname: Cota
authors.forename: Chiara
authors.initials: C
authors.lastname: Panetta
authors.forename: Luca Maria
authors.initials: LM
authors.lastname: Muscardin
authors.forename: Pietro
authors.initials: P
authors.lastname: Donati
mesh_terms: D000369:Aged, 80 and over; D006394:Hemangiosarcoma / Q000473:pathology*; D006801:Humans; D008297:Male; D012535:Scalp / Q000473:pathology*; D012878:Skin Neoplasms / Q000473:pathology*