Clinically suspected eyelid conjunctival metastasis from cutaneous angiosarcoma responding to palliative radiotherapy: Report of a case

Introduction: Cutaneous angiosarcoma is a rare and highly aggressive vascular malignancy that commonly arises on the scalp and face of elderly individuals. It frequently metastasizes to visceral organs, whereas ocular involvement is exceedingly uncommon. Case presentation: We report a case of clinically suspected eyelid conjunctival metastasis from cutaneous angiosarcoma in a man in his 60s. The primary tumor involved the left scalp and cheek and was treated with intensity-modulated radiotherapy combined with weekly paclitaxel for seven months. Although an initial response was observed, the disease progressed with distant metastases to the lungs, liver, and brain. During the terminal stage, a rapidly enlarging hemorrhagic lesion developed on the conjunctiva of the right eyelid, outside the previously irradiated field. Because of the patient’s poor general condition, histopathological confirmation was not feasible. Based on the clinical course and characteristic appearance, the lesion was clinically diagnosed as conjunctival metastasis. Short-course palliative radiotherapy achieved effective hemostasis and symptomatic relief. Conclusion: This case highlights an unusual metastatic presentation of cutaneous angiosarcoma and supports the role of palliative radiotherapy in managing symptomatic ocular lesions.