Skin nonmelanocytic tumor

Vascular tumors


Last author update: 1 October 2016
Last staff update: 13 September 2021

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PubMed Search: Angiosarcoma [title] skin "loattrfree full text"[sb]

Joel Tjarks, M.D.
Page views in 2022: 3,655
Page views in 2023 to date: 374
Cite this page: Tjarks J. Angiosarcoma. website. Accessed February 6th, 2023.
Definition / general
  • Malignant neoplasm with vascular differentiation
Essential features
  • Infiltrative vascular neoplasm with broad histologic profile ranging from a well differentiated neoplasm with frank vascular differentiation to a poorly differentiated tumor with epithelioid or spindled cells
  • May mimic poorly differentiated carcinoma, inflammatory process, lymphoma or melanoma
  • Also known as hemangiosarcoma
  • Classically arises in one of three scenarios:
    • Head and neck of the elderly
    • Chronic lymphedema
    • Postradiation (usually in the setting of breast cancer)
  • Sun exposed skin of the elderly (head and neck); breast with history of lymphedema or radiation therapy
Clinical features
  • Wide age range (most common in adults)
  • Presents as purple nodules or plaques
  • Highly aggressive
  • Frequent recurrence and metastasis
Prognostic factors
  • Poor prognosis - high mortality
  • Epithelioid tumors are often more aggressive
Case reports
  • Surgical resection with negative margins
  • Chemotherapy is occasionally used
Clinical images

Images hosted on other servers:

Scalp, neck and breast lesions

Gross description
  • Violet elevated nodules with ill defined margins
Microscopic (histologic) description
  • Infiltrating, freely anastomosing channels lined by spindled to epithelioid endothelial cells with variable atypia, surrounding adnexae and dissecting dermal collagen
  • Endothelial cells may have multilayered appearance
  • May have free floating intraluminal endothelial cells (“fish in the creek”)
Microscopic (histologic) images

Contributed by Hillary Rose Elwood, M.D.

High grade atypical vascular tumor

Atypical vascular tumor involving dermis and subcutis

High power view showing the vascular proliferation dissecting throughout the dermal collagen and lined by atypical endothelial cells

Contributed by Joel Tjarks, M.D.
Missing Image

Various images

Positive stains
Negative stains
Molecular / cytogenetics description
  • MYC (8q24) amplification seen in great majority radiation / lymphedema associated tumors
Differential diagnosis
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