Cutaneous Angiosarcoma in a Psoriasis Patient on Infliximab and Methotrexate Therapy

Abstract

Angiosarcoma is a soft tissue sarcoma of endothelial origin that can arise in any organ, with an incidence of up to 5% of all malignant cutaneous tumors. It is the 4th most common sarcoma of the skin and typically occurs on the scalp of white men over 60 years of age. Its prognosis is traditionally very poor, with 5-year survival rates reported as low as 11%. Risk factors for cutaneous angiosarcoma have not been clearly established. Herein, we describe a 64-yearold male with a chronic history of psoriasis maintained on methotrexate and infliximab for over 10 years, who presented with a 7-week history of a cluster of reddish-blue, violaceous nodules on his occipital scalp. Biopsy showed classic features of angiosarcoma. He was treated with multimodal therapy. Six years subsequent to his initial diagnosis he continues in remission, with no evident signs of recurrence or further metastases.