PMC6032971_01
A bluish-violaceous discoloration is seen under her scalp.
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fig1
On initial examination, a large purplish mass on the skin of the frontal scalp was identified [Figure 1].
The cells are uniformly positive for vimentin, a nonspecific stain that confirms the mesenchymal origin of tumors.
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fig2
An incisional biopsy was performed, which revealed angiosarcoma [Figures 2, 3, and 4].
The anastomosing channels are readily apparent and are lined with atypical endothelial cells with enlarged and hyperchromatic nuclei.
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fig3
An incisional biopsy was performed, which revealed angiosarcoma [Figures 2, 3, and 4].
The neoplastic cells also express CD31, a relatively sensitive and specific marker for endothelial cells that is also positive in vascular tumors, including angiosarcoma.
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fig4
An incisional biopsy was performed, which revealed angiosarcoma [Figures 2, 3, and 4].
A 2.8 cm focal lesion was identified on the anterior aspect of the right submandibular gland representing an enlarged lymph node. A smaller, 1.6 cm enlarged lymph node was also present on the left side.
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fig5
Imaging showed frontal scalp swelling with multiple enlarged lymph nodes concerning metastatic disease [Figure 5].