A case of lymphangiosarcoma on the cheek

A 63-year-old man visited a dermatology clinic in January 2008 for swelling of his left cheek, which started in September 2007. He was diagnosed as having erysipelas and administered antibiotic. As the symptoms did not improve, a biopsy was performed. Because angiosarcoma was suspected histologically, he was referred to our hospital. On physical examination, a diffuse swelling appeared over his left cheek, without obvious purpura. The biopsied specimen showed that atypical tumor cells formed pseudovascular-type structures without red blood cells. Immunohistochemically, these tumor cells were negative for CD34, but positive for CD31 and D2-40 staining. Based on these findings, we diagnosed this case as having lymphangiosarcoma. Treatment was innitiated with monthly paclitaxel (175 mg/m²)and radiation (total 70 Gy). The tumor decreased gradually in size and currently remains without metastasis.