Department of Dermatology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
The Skin Hospital, Darlinghurst, New South Wales, Australia.
BMJ Case Rep. 2024 Sep 12;17(9):e258751. doi: 10.1136/bcr-2023-258751.
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.
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。
