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%.
Sources
Based on clinical guidelines from the American Academy of Dermatology (AAD) and British Association of Dermatologists (BAD). Statistics from NCI SEER Program and IARC GLOBOCAN. Staging per AJCC Cancer Staging Manual, 8th ed. Full methodology