Admixed foamy cell and signet ring cell change in a cutaneous angiosarcoma - A diagnostic pitfall

Cutaneous epithelioid angiosarcomas are known to exhibit various morphological variations. The present case is first of its own kind describing admixture of foamy cell and signet ring cell morphological patterns in a case of cutaneous angiosarcoma occurring in a 64-year-old female. The initial incisional biopsy revealed predominantly cytoplasmic vacuolations in the tumor cells with only focal presence of typical angiosarcomatous component, while in subsequent resection specimen, these variations were present only focally with predominant classical angiosarcomatous areas. This case highlights the importance of awareness of such morphological variations in angiosarcomas as these can be easily missed or misdiagnosed in small biopsies due to sample selection.