Histopathological diagnosis of cutaneous vascular sarcomas

Abstract Cutaneous sarcomas represent a heterogeneous group of mesenchymal lesions. This study investigates the histopathological and immunohistochemical features in different cases of angiosarcoma and Kaposi’s sarcoma (cutaneous vascular sarcomas), which are representative for medical practice. The clinical–histopathological–immunohistochemical correlations render possible the differential diagnosis and a proper treatment can be applied to obtain a favorable prognosis. Keywords : angiosarcoma, Kaposi’s sarcoma, immunohistochemistry, vascular sarcomas.  The treatment of cutaneous sarcomas consists of Introduction Skin cancers account for 15–20% of all malignant tumors. Cutaneous sarcomas are relatively rare malignant connective tissue tumors – almost 5% of all cutaneous malignant tumors. Cutaneous sarcomas represent a heterogeneous group of mesenchymal neoplasms including fibro-histiocytic tumors (atypical fibroxantoma, dermato-fibrosarcoma protuberans), fibroblast tumors (fibro-sarcoma, myxofibrosarcoma), smooth muscle tumors (leiomyosarcoma), skeletal muscle tumors (rhabdo-myosarcoma), peripheral nerve sheath tumors (malign-ant perineural sheath tumor, MPNST), lipomatous tumors (liposarcoma), and vascular tumors (angio-sarcoma, Kaposi’s sarcoma) [1–7]. Frequently, sarcomas are found in older adults. Sarcomas are usually manifested by deep lesions and they may also affect the subcutaneous tissue. The preferential sites are the extremities, especially the thigh, then trunk, head and neck and retroperitoneum. Most sarcomas appear spontaneously and do not have a known etiology. Cutaneous lesions present as plaques or nodules. Their main characteristics are cellular and nuclear atypia, rapid, invasive and destructive growth, metastases and a high tendency to local recurrences [1, 3, 8–12]. The general information about the patient (age, sex, pathological history) together with the specific data about the tumor (size, location, growth pattern, atypia, mitotic rate, presence of necrosis, ulceration and hemorrhage areas) are important features for a correct diagnosis and prognosis evaluation [13–18]. surgical excision, radiotherapy and chemotherapy [1, 3, 4, 14]. These article reviews cutaneous vascular sarcomas with particular emphasis on the histopathologic and immunohistochemical features for diagnostic, treatment and prognostic purpose.