Cutaneous Angiosarcoma of the Scalp Aggravated after Hair Dyeing Presenting as Bilateral Facial Cellulitis: A Case Report

Abstract

Angiosarcoma is a rare and aggressive soft tissue sarcoma. The cutaneous form of angiosarcoma occurs most commonly in the head and neck region, especially the scalp. Because of its aggressiveness and tendency for distant metastasis and local recurrence, early diagnosis of angiosarcoma is critical. We report a case of cutaneous angiosarcoma of the scalp aggravated by hair dyeing. In this case, it presented as bilateral facial cellulitis because of the progression of an infection. The patient was not aware of his malignant lesions on the scalp since they are typically hidden. Meanwhile, infection caused by chemical stimulation from hair dye exacerbated the lesions. However, an early incisional biopsy revealed angiosarcoma with metastasis to the lymph nodes and parotid glands, leading the patient to appropriate chemotherapy. In conclusion, the variable and non-specific findings of cutaneous angiosarcoma can delay the diagnosis; thus, the importance of an excisional or incisional biopsy, which can result in early diagnosis when suspecting malignancy, is highlighted.