SARCOMA MẠCH MÁU NGUYÊN PHÁT Ở DA: THÁCH THỨC TRONG CHẨN ĐOÁN NHÂN MỘT TRƯỜNG HỢP LÂM SÀNG

Abstract

Objective: To describe the clinical and paraclinical characteristics of a case of primary cutaneous angiosarcoma diagnosed at Hanoi Dermatology Hospital. Subjects and methods: A case report. The patient was a 72-year-old male presenting with a purplish-red plaque on the scalp. The surface was ulcerated and bleeding, but the lesion was painless and non-pruritic. Multiple biopsies were required before malignant cells were detected. Histopathological examination revealed proliferating vascular structures with hyperplastic, round, enlarged, hyperchromatic endothelial cells; narrowed vascular lumens; areas of anastomosis or complete occlusion by endothelial cells; and frequent mitotic figures. Immunohistochemistry was positive for ERG, CD34, and Ki-67 (20%), and negative for CKAE1/AE3. Results: The patient was diagnosed with cutaneous angiosarcoma-a rare malignant tumor originating from vascular or lymphatic endothelial cells. The clinical manifestations are diverse and easily confused with trauma, Kaposi’s sarcoma, cicatricial alopecia, and other conditions. Histopathology and immunohistochemistry play crucial roles in establishing the diagnosis. Conclusion: This case highlights the importance of recognizing cutaneous angiosarcoma and underscores the essential role of histopathological and immunohistochemical evaluation in its accurate diagnosis.