Low-grade cutaneous epithelioid angiosarcoma in the axilla

Abstract

Case report: A 25-year-old male patient, with no relevant medical history, presented after several-month history of evolution with an erythematous- violaceous papule in the left axilla. The lesion was non-ulcerated, non-bleeding, had well-defined borders, and was painful on palpation. Initial differential diagnoses included an inflamed fibroma and wart. An excisional biopsy revealed a dermal neoplasm composed of polygonal epithelioid cells with eosinophilic cytoplasm, intracytoplasmic vacuoles, vascular channels containing erythrocytes, and involvement of surgical margins. Immunohistochemistry showed positivity for CD34, a Ki-67 index of 30%, and negativity for AE1/AE3 and EMA. A diagnosis of lowgrade epithelioid angiosarcoma was established. A second biopsy confirmed these findings.

Conclusions: Cutaneous epithelioid angiosarcoma may present as a seemingly benign lesion, underscoring the importance of complete histopathological evaluation in persistent atypical lesions. Early identification and adequate surgical excision are essential due to its aggressive behavior.