Angiosarcoma
Rare cancer of blood or lymph vessels. Often appears as a bruise-like patch on the scalp of elderly patients.
What to look for
Side-by-side comparison
Normal scalp
No persistent bruising
Possible AS
Bruise-like patch, not healing
Angiosarcoma is a rare, aggressive cancer that develops from the cells lining blood vessels or lymph vessels. It accounts for less than 2% of all soft tissue sarcomas. Cutaneous angiosarcoma most commonly affects the scalp and face of elderly patients, particularly men.
The initial appearance is deceptively benign - it often looks like a bruise, a purple patch, or a raised nodule on the scalp. It may resemble a hematoma or an area of inflammation. This innocuous appearance frequently leads to delayed diagnosis.
Angiosarcoma can also develop in areas of chronic lymphedema (Stewart-Treves syndrome) - for example, in an arm affected by lymphedema after breast cancer surgery. Radiation-induced angiosarcoma is another recognized form, occurring in previously irradiated tissue, sometimes decades after radiation therapy.
Unfortunately, angiosarcoma has a poor prognosis overall, with a five-year survival rate of approximately 30-40%. This is partly because it is often diagnosed at an advanced stage due to its misleading early appearance.
Quick self-check
Does this look like angiosarcoma? Answer 2 questions.
Does the area look like a bruise or purple patch that does not go away?
Is it on the scalp or in an area of chronic swelling or previous radiation?
Risk factors
- Age over 70
- Chronic lymphedema (especially post-mastectomy)
- Previous radiation therapy
- Chronic sun exposure on fair skin (scalp in bald men)
- Exposure to certain chemicals (vinyl chloride, arsenic)
When to see a dermatologist
- ⚠A bruise-like purple patch on the scalp that does not resolve
- ⚠A growing purple or dark red nodule on the face or scalp
- ⚠Skin changes in an area of chronic lymphedema
- ⚠New skin lesions in a previously irradiated area, even decades later
Often confused with
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Why is angiosarcoma so dangerous?
Angiosarcoma is aggressive, tends to recur locally even after surgery, and has a high rate of distant metastasis. Combined with its misleading early appearance (looks like a bruise), it is often diagnosed late. The five-year survival rate is approximately 30-40%.