“Pseudolymphomatous” angiosarcoma mimicking rhinophyma — case report and focused review of the literature

Background Rhinophyma is usually considered a benign late-stage manifestation of rosacea and is often treated for functional or aesthetic reasons. However, malignant tumors may clinically resemble or arise within rhinophymatous tissue. Cutaneous angiosarcoma is an aggressive vascular malignancy that predominantly affects elderly patients and may present with deceptively nonspecific inflammatory or rosacea-like changes. Methods Case report and focused PubMed/MEDLINE literature review was performed for angiosarcoma mimicking rhinophyma or rosacea-like disease and for malignancies detected in rhinophyma. Results A rare case of angiosarcoma mimicking recurrent rhinophyma is presented. The literature overview includes nine previously reported cases directly associated with rhinophyma and rosacea-like presentations. Other malignancies e.g. basal cell carcinoma (BCC) or squamous cell carcinoma (SCC) are more frequent with occurrence rates of about 1-10%. Conclusion Aggressive malignancies may be concealed within recurrent rhinophyma, even in the absence of clinically suspicious features. Routine histopathological examination of all surgically removed rhinophyma tissue is therefore mandatory.