The biopsy specimen revealed an infiltrate of atypical epithelioid cells forming anastomosing channels and dissecting the dermal collagen. Occasional vascular spaces were lined by atypical cells jutting from the lumen. Immunoperoxidase stains to assess tumor phenotype were positive for CD31 and vimentin.
Chest radiography showed a focal nodular density in the anterior segment of the left upper lobe. A confirmatory computed tomographic scan of the chest identified only a 2-mm nodule in this area, a finding that was suggestive of a benign intrapulmonary lymph node. No other suspicious lesions were identified by physical examination or imaging studies. The results of serological evaluation were unremarkable. The patient underwent Mohs micrographic surgery for excision of the angiosarcoma, with subsequent repair. She also received 7 weeks of adjuvant radiation therapy (total dose, 5600 rad [56.0 Gy]). Eleven months after surgery, she was doing well, without evidence of local recurrence or metastasis.
Enlarging Red Plaque on the Nose of an Elderly Woman. Arch Dermatol. 2002;138(6):831-836. doi:10.1001/archderm.138.6.831