A Latin American woman in her 50s with a history of breast cancer status post lumpectomy and adjuvant radiation therapy presented with a 3-month history of a right neck nodule and purpuric rash on her right cheek. The growing nodule and rash were thought to be lymphadenopathy by an outside clinician before she presented to our dermatology clinic 3 months later. She endorsed progressive swelling around the right eye but denied systemic symptoms. Physical examination revealed a large, purpuric plaque involving most of her right face with associated periorbital swelling but without ulceration. Two punch biopsy specimens demonstrated a proliferation of vessels lined by CD31+, D2−40+, MYC+, and HHV8− atypical crowded endothelial cells, which was consistent with angiosarcoma. Imaging results demonstrated tumor involvement of the orbit, fascia, and platysmas and suggested pulmonary, pleural, osseous, and nodal metastases.
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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
Corresponding Author: Arturo R. Dominguez, MD, Department of Dermatology, University of Texas Southwestern Medical Center, 5939 Harry Hines Blvd, Ste 400, Dallas, TX 75390-9191 (firstname.lastname@example.org).
Published Online: January 18, 2023. doi:10.1001/jamadermatol.2022.5446
Conflict of Interest Disclosures: None reported.
Additional Contributions: We thank the patient for granting permission to publish this information. We also thank Heather Goff, MD, and Rebecca Vasquez, MD, University of Texas Southwestern Medical Center, for their insights on this case, for which they were not compensated.
Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:
It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.
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