Angiosarcoma Scalp: An Under-Reported and UnderDiscussed yet Aggressive Entity

Angiosarcoma is a rare malignant soft tissue sarcoma and carries a very poor prognosis because of its multifocal and aggressive behaviour. Angiosarcoma most commonly occurs in head and neck region but can involve any organ of the body. This often occurs in elderly males with a male preponderance. It may mimic benign vascular region clinically but as the lesion grows with time it may ulcerate a wedge biopsy provides the diagnosis. Surgical excision is so far described as a best treatment modality and radiation treatment and chemotherapy are used as an adjunct to surgical excision. An excision with positive resection margins on histopathological examination cannot be complemented with the adjuvant radiation therapy and re- wide excision needs to be considered as there are always chances for the disease recurrence. Chemotherapeutic agents claim to improve response rates and overall survival in a metastatic angiosarcoma. Molecular researches have shown the presence of biological molecules in the lesion and hence targeted chemotherapeutic agents may prove to be useful in some cases though no randomised trials are there in literature till date to prove the use of targeted agents in angiosacrcoma scalp. Recent animal studies have been shown to have longer progression free survival with the use of combination β- adrenergic blocker and metronomic chemotherapy.