Progressive solid facial edema: A neglected clue to cutaneous angiosarcoma

Abstract

Introduction: Cutaneous angiosarcoma (CAS), a rare and highly aggressive tumor derived from vascular endothelial cells, has quite poor prognosis and the clinical presentations are occasionally atypical and inconspicuous, frequently leads to the delayed diagnosis. Case presentation: We here described an unusual, initial presentation of CAS manifested as solid facial edema and induration, which appeared asymptomatic, unilateral and gradually spread. The histopathological and histochemical results helped confirm the diagnosis and Paclitaxel combined with Bevacizumab was taken for two cycles which had acquired significant relief but suspended for the poor tolerance. Discussion: Apart from typical skin lesions observed as single or multiple erythematous to violaceous plaques, papules or nodules that tend to ulcerate or bleed, the CAS occasionally mimics other diseases such as cellulites, rosacea, rhinophyma and , also as we reported, that initiated as inconspicuous but progressive facial edema. Conclusion: The field of CAS therapy has been growing rapidly nowadays whereas the survival rate has not yet improved significantly. Early diagnosis is necessary and CAS should be considered when it comes to patients presented with progressive solid facial edema after ruling out common causes.