VERRUCOUS ANGIOSARCOMA OF THE SKIN - A DISTINCT VARIANT OF CUTANEOUS ANGIOSARCOMA

Aims: Cutaneous angiosarcoma is a malignant vascular neoplasm with wel l established clinical and histopathological features. Epidermal chang es in cutaneous angiosarcoma other than atrophy and necrosis have not been described. In this study, we report three cases of a peculiar var iant of angiosarcoma with striking verrucous changes of the overlying epidermis. Methods and results: On light microscopy, verrucous changes characterized by marked pseudocarcinomatous epithelial hyperplasia wi th hypergranulosis, compact orthokeratosis, and papillomatosis were pr esent overlying an angiosarcoma in the dermis. Clinically the lesions presented as violaceous to brown scaly verrucous nodules or plaques. A ll lesions developed on an extremity. Conclusions: Verrucous epidermal changes seem to be a manifestation of pseudocarcinomatous hyperplasia , presumably caused by lymphoedema and the superficial setting of the tumour in the papillary dermis. It is important to be aware of this pr esentation of angiosarcoma because verrucous epidermal changes may be seen in a wide variety of skin diseases, Furthermore, a biopsy that in cludes the dermis is necessary to ensure that the angiosarcoma underly ing the hyperplastic epidermis is correctly identified, The descriptiv e appellation verrucous angiosarcoma of the skill is proposed to desig nate a newly recognized variant of angiosarcoma.