Abstract
A 90-year-old man noted a red nodule on the right temple in 2009. In April 2013, physical examination revealed a red nodule, 30mm in diameter, and an enlarged lymph node in the right cervix. Histologically, the red nodule consisted of pleomorphic cells with spindle to ovoid nuclei and lumen of vessels in subcutis. Immunohistochemistry indicated that tumor cells were positive for CD31 and vimentin. The cervical lymph node showed histology similar to that of the cutaneous nodule. We diagnosed this case as cutaneous angiosarcoma with cervical lymph node metastasis. Furthermore, serum HCV antigen and PIVKA-II were remarkably increased, and contrast-enhanced CT scan revealed a solitary hepatic nodule, 50 mm in diameter, with hyperenhancement on arterial phase and wash out from the lesion on delayed phase. He was diagnosed as having hepatocellular carcinoma. The skin tumor was broadly excised in April, and right cervical lymph node dissection was performed in May. After the dissection, enlargement of the hepatic tumor and multiple pulmonary nodules were present. The patient died in February 2014.[Skin Cancer (Japan) 2014 ; 29 : 303-308]
