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Open Access Case report

Infraorbital cutaneous angiosarcoma: a diagnostic and therapeutic dilemma

Tobias Ettl1, Johannes Kleinheinz2*, Ravi Mehrotra3, Stephan Schwarz4, Torsten E Reichert1 and Oliver Driemel1

Author Affiliations

1 Department of Oral and Maxillofacial Surgery, Regensburg University, Germany

2 Department of Oral and Maxillofacial Surgery, Muenster University, Germany

3 Department of Pathology, Moti Lal Nehru Medical College, Allahabad University, India

4 Department of Pathology, Erlangen University, Germany

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Head & Face Medicine 2008, 4:18  doi:10.1186/1746-160X-4-18

Published: 11 August 2008

Abstract

Background

A cutaneous angiosarcoma is a rare malignant tumour of vascular endothelial cells with aggressive clinical behaviour and poor prognosis. Diagnosis is often delayed due to its variable and often benign clinical appearance.

Case presentation

This case presents a 64-year-old man with a six-month-history of a recurrent diffuse and erythematous painless swelling below the left eye. Several resections with intraoperatively negative resection margins followed, but positive margins were repeatedly detected later on permanent sections. Histopathologic examination of the specimen diagnosed a cutaneous angiosarcoma. Neither, finally achieved negative margins on permanent sections, nor a following chemotherapy could prevent the recurrence of the disease after five months and the patient's dead 21 months after the first diagnosis.

Conclusion

The case elucidates the current diagnostic and therapeutic dilemma of this entity, which shows an unfavourable clinical course in spite of multimodal therapy.