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识别以增大性瘀斑为表现的血管肉瘤。

Recognising angiosarcoma presenting as an enlarging ecchymotic plaque.

机构信息

Department of Dermatology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia

The Skin Hospital, Darlinghurst, New South Wales, Australia.

出版信息

BMJ Case Rep. 2024 Sep 12;17(9):e258751. doi: 10.1136/bcr-2023-258751.

Abstract

Cutaneous angiosarcoma (cAS) is a rare malignant neoplasm of vascular endothelial origin with an unfavourable prognosis. Its diagnosis often faces delays due to its manifestation as an inconspicuous 'bruise-like' lesion in an otherwise asymptomatic individual, leading to a generally low index of suspicion for angiosarcoma. Here, we present a case of a man who presented to his general practitioner with an ecchymotic plaque on his forehead, initially thought to be benign. Over the subsequent 6 weeks, the lesion progressively enlarged and became ulcerated, prompting the patient to represent to his general practitioner. He was urgently referred to a dermatologist and a subsequent biopsy confirmed the diagnosis of cAS. Our presentation of this case serves as a reminder for physicians to maintain a high index of suspicion and low threshold for biopsy for patients with atraumatic ecchymotic lesions.

摘要

皮肤血管肉瘤(cutaneous angiosarcoma,cAS)是一种罕见的血管内皮来源的恶性肿瘤,预后不良。由于其表现为无症状个体中不起眼的“瘀斑样”病变,其诊断常常存在延迟,导致对血管肉瘤的怀疑普遍较低。在这里,我们报告了一例男性患者,他因额头上出现瘀斑斑块而就诊于全科医生,最初被认为是良性的。在接下来的 6 周内,病变逐渐扩大并出现溃疡,促使患者就诊于全科医生。他被紧急转介给皮肤科医生,随后的活检证实了 cAS 的诊断。我们报告这个病例是为了提醒医生,对于无创伤性瘀斑性病变的患者,要保持高度怀疑和低活检阈值。

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