Skin as a window to systemic metastases: a rare case of breast angiosarcoma

Angiosarcoma of the breast is a rare and aggressive vascular malignancy with a high metastatic potential. Cutaneous involvement may serve as an early indicator of systemic dissemination. We report a case of a 62-year-old female with primary breast angiosarcoma who presented with multiple erythematous papules on the scalp, face, and chest, including over the mastectomy scar. Biopsy con-firmed cutaneous metastases of angiosarcoma. Further investigations revealed widespread metastases to the lungs, gastrointestinal tract, liver, and bones. Given its rarity, breast angiosarcoma poses significant diagnostic and therapeutic challenges. Despite surgical intervention, the prognosis remains poor due to early and extensive haematogenous spread. This case highlights the importance of recognising cutaneous metastases as an early manifestation of systemic disease and underscores the role of dermatologists in the early diagnosis and multidisciplinary management of angiosarcoma. Prompt histopathological confirmation is crucial for guiding treatment decisions and improving patient outcomes.