Clinical Two Cases of an Angiosarcoma on the Scalp

Kim, Se Jin; Kim, Jong Hwan; Hong, In Pyo

Abstract

Angiosarcoma is very rare malignant tumor originated from endothelial cells. Angiosarcoma has four clinical types that are in the scalp and face of old age people, in chronic lymphedema, in irradiating therapy and in malignant proliferative angioendothelioma. We report two cases of angiosarcoma developed in the scalp. A 66-year-old male in whom angiosarcoma developed in the occipital area. The lesion was 4.0x4.5cm sized dark-red colored, ill-defined mass. We performed wide excision with partial removal of outer table of skull, and subsequently covered with local flap and split-thickness skin graft. There was an evidence of metastasis to the lung, rib and lumbar vertebral area after postoperative 8 months. The patient died in 11 months after operation due to metastasis to the lung. A 79-year-old male patient with similar history; lesions in the left frontal scalp(4.5x5.0cm), left temporal area (3.5x5.0cm) were brownish, and ulcer was noted in the left temporal scalp lesion. We performed wide excision with partial removal of outer table of skull, and subsequently covered with superficial temporalis fascia rotation flap and split-thickness skin graft. Postoperatively the patient underwent radiotherapy for recurrence prevention, but the patient died in 7 months after operation due to metastasis to the lung and liver. The prognosis of angiosarcoma is very poor because of frequent local recurrence and early metastasis. Important factors to consider in prognosis are the size of mass and prompt surgical excision.