中国麻风皮肤病杂志 ›› 2026, Vol. 42 ›› Issue (11): 799-802.doi: 10.12144/zgmfskin202611799

• 病例报告 • 上一篇    下一篇

头皮血管肉瘤一例

李梅,陈宁刚,叶静静,胡致恺   

  1. 浙江中医药大学附属宁波市中医院，浙江宁波，315000
  • 出版日期:2026-11-15 发布日期:2026-10-29

Scalp angiosarcoma: a case report

LI Mei, CHEN Ninggang, YE Jingjing, HU Zhikai   

  1. Ningbo Municipal Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Ningbo 315000, China
  • Online:2026-11-15 Published:2026-10-29

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摘要： 患者,男，50岁。头皮丘疹伴瘙痒3个月、加重伴糜烂渗出2个月。皮损初为黄豆大小红色丘疹，伴瘙痒，搔抓后破溃渗液，组织病理示真皮内不规则血管腔增生，内皮细胞明显异型，可见核分裂象；免疫组化示血管内皮标志物CD31(+)、CD34(+)、ERG(+)、Fli-1(+)，HHV-8(-)，Ki-67(+，约10%)。结合PET-CT提示肝、骨、多发淋巴结转移，确诊为头皮血管肉瘤（IV期）。2025年6—11月予替雷利珠单抗联合脂质体多柔比星+异环磷酰胺方案化疗，皮损逐渐缩小、渗血停止，截至2026年5月随访，皮损基本平复，无新发转移。

关键词: 血管肉瘤, 头皮, 免疫联合化疗, 误诊, 转移

Abstract: A 50-year-old male patient was admitted to hospital due to scalp papules with pruritus for 3 months, which worsened accompanied by erosion and exudation for 2 months. The initial lesion presented as soybean-sized red papules with itching, which ruptured and exuded fluid after scratching. Histopathology revealed proliferation of irregular vascular lumens in the dermis with obvious atypical endothelial cells and visible mitotic figures. Immunohistochemistry showed positive expression of vascular endothelial markers CD31, CD34, ERG and Fli-1, negative HHV-8, and Ki-67 positive (approximately 10%). Combined with PET-CT findings indicating liver, bone and multiple lymph node metastases, the patient was diagnosed with stage IV scalp angiosarcoma. From June to November 2025, the patient received chemotherapy with tislelizumab combined with liposomal doxorubicin plus ifosfamide. The lesions gradually shrank and bleeding exudation ceased. Follow-up till May 2026 showed that the lesions basically subsided without newly developed metastases.

Key words: angiosarcoma, scalp, immunotherapy combined with chemotherapy, misdiagnosis, metastasis