Sepsis Associated With Aggressive Cutaneous Angiosarcoma

Abstract

Cutaneous angiosarcoma is an aggressive tumor most commonly presenting on the head and neck. In this case report, we describe the presentation of sepsis secondary to an aggressive and rapidly expanding wound, located in a sun-protected area on the body, in a patient with multiple concurrent comorbidities. Treatment was tailored toward targeting the causative organisms, as well as identifying the histologic morphology of the pathologic legion. Histopathology and immunohistochemistry were used to confirm the diagnosis of cutaneous angiosarcoma, and the patient-centered decision surrounding palliative chemotherapy is outlined.

Keywords: cutaneous angiosarcoma; cutaneous malignancy; dermatopathology; sepsis; skin cancer.

Figure 1. Demonstration of the violaceous, indurated, and ulcerating plaques and nodules involving the right flank and right mid-lower quadrant of the abdomen. Edema of the surrounding tissue is also visible.

Figure 2. A closeup of the lesion

Cobblestone appearance and purulent drainage are noted.

Figure 3. Histopathology of the punch biopsy

Note the pleomorphic and hypercellular endothelial cells with entrapment of the collagen bundles. Hematoxylin and eosin stain at 200x magnification