RESUMO
Cutaneous epithelioid angiosarcoma is a rare malignant vascular tumor, most commonly affecting elderly men, and is usually located on the extremities. We report a case of an 81-year-old lady who presented with two ulcerated plaques over the right temporal and parietal scalp of 1 year duration. The right submaxillary and submandibular lymph nodes were enlarged and tender. Computed tomography (CT) scan of the head showed soft tissue swelling over parietal and temporal areas and there was no intracranial extension. Ultrasonogram of the abdomen showed hyperechoic areas in liver suggestive of secondaries. Histopathology of the skin lesion showed the dermis and subcutis composed of clusters of atypical epithelioid cells with vesicular nuclei, prominent nucleoli and eosinophilic cytoplasm with increased mitotic figures. Immunohistochemical staining revealed CD-31, 33, 34 and vimentin positivity, while cytokeratin was negative confirming the diagnosis of epitheloid angiosarcoma. This case report highlights the unusual occurrence of multicentric epitheloid angiosarcoma on the scalp with secondaries in the liver.
RESUMO
A 41 year-old, sexually promiscuous, married male, an agricultural laborer by occupation, presented to our sexually transmitted diseases (STD) clinic with multiple ulcers over the scrotum and genitalia of 20 days' duration. Bacterial culture from swabs taken from the genital ulcer, grew organisms morphologically and biochemically characteristic of Corynebacterium diphtheriae. He made a complete and uneventful recovery after two weeks of therapy with antidiphtheria serum and crystalline penicillin. This case brings into light this hitherto unreported presentation of wound diphtheria mimicking a sexually transmitted genital ulcer disease and thus, underlines the importance of considering diphtheria as differential in atypical, long-standing genital ulcers.