When a Bruise Is Not Just a Bruise: Cutaneous Angiosarcoma Diagnosed in Primary Care
Abstract:
Cutaneous angiosarcoma is a rare and highly aggressive vascular malignancy that often presents with non specific clinical features, leading to delayed diagnosis and poor prognosis. Early lesions may resemble benign conditions such as bruises or hematomas, particularly in elderly patients and those receiving anticoagulant therapy. We report the case of an 88-year-old woman who presented in a primary care setting with a progres sive violaceous lesion involving the scalp and facial region, initially interpreted as a spontaneous bruise. De spite conservative management, the lesion rapidly enlarged and was associated with periorbital edema. His topathological examination of a skin punch biopsy confirmed the diagnosis of cutaneous angiosarcoma, with subsequent imaging revealing extensive local invasion, including osteolytic involvement of the parietal bone. Due to advanced disease stage, age, and comorbidities, curative treatment was not feasible, and the patient was referred for palliative care. This case highlights the diagnostic challenges of cutaneous angiosarcoma in primary care and underscores the importance of maintaining clinical suspicion and performing early biopsy in persistent or atypical bruise-like lesions to facilitate timely diagnosis and management.
