Herein, we report a case of cutaneous angiosarcoma in a 35-year-old, morbid
ly obese woman. The tumor arose in the most dependent portion of the lower
abdominal panniculus and showed typical changes of chronic lymphedema. The
patient underwent a radical resection of her lower abdominal wall panniculu
s, which showed a multicentric, high-grade angiosarcoma with bilateral supe
rficial inguinal lymph node metastases. Histologically, conventional vasofo
rmative areas were admired with poorly differentiated sheets of spindle and
epithelioid cells. Factor VIII was focally positive (membranous), whereas
CD31 showed robust, diffuse positivity (membranous and cytoplasmic). The in
itial margins of resection were negative, and no followup radiation or chem
otherapy was given. Following a recurrence at the previous excision site, t
he patient died 7 months after the surgery. Postmortem examination revealed
a widely metastatic tumor that involved multiple organ systems. We believe
this is the second report of cutaneous angiosarcoma occurring in a chronic
ally lymphedematous abdominal panniculus due to morbid obesity.