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Course: Angiosarcoma Mimicking Rhinophyma

CME Credits: 1.00

Released: 2022-11-16

A man in his 60s was referred to the department of dermatology for further evaluation of a lesion on the nose. The patient had seen a dermatologist 1.5 years earlier with redness and enlargement of the nasal tip. The clinical diagnosis of rhinophyma was made. During the next year, the patient was treated several times using a combination of carbon dioxide laser and pulsed dye laser, with easy bleeding and recurrence. Physical examination showed a bright red mass on the nasal tip with vascularity and branching vessels (). Magnetic resonance imaging showed a soft-tissue mass with contrast enhancement. A skin biopsy was performed and showed a tumoral proliferation consisting of atypical, poorly differentiated cells with epithelioid features in the deep dermis with a normal overlying epidermis. The tumor demonstrated a solid growth pattern; however, several immature slitlike lumina were also noticed. The tumoral nests were surrounded by a dense nodular infiltrate of lymphocytes and histiocytes. Immunohistochemistry findings showed high expression of CD31, CD34, factor VIII-related antigen, and erythroblast transformation-specific related gene. In addition, the tumor displayed low CD68 expression. These findings were considered to be consistent with cutaneous angiosarcoma. Staging using positron emission tomography/computed tomography showed no distant metastases. The patient received a partial rhinectomy followed by adjuvant radiotherapy and was disease free 12 months after treatment.


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