Angiosarcoma (angioendothelioma) of the scalp. An unusual case of scarring alopecia.

Angiosarcoma with initial involvement of the scalp is a rare, malignant neoplasm. We present the case of a 77-year-old woman in whom extensive scarring alopecia developed that was proved histologically to be due to angiosarcoma. She had a good initial response to treatment with electron-beam therapy, but after seven months, extensive nodules and indurated areas on the face beyond the borders of the radiation field developed. Subsequently, massive cervical adenopathy and metastases to the lungs, liver, and spleen developed. Angiosarcoma must be differentiated from other malignant blood vessel tumors and should be considered in the differential diagnosis of scarring alopecia of the scalp in elderly patients.