Extensive angiosarcoma of the scalp involving the cranium

A case of angiosarcoma of the scalp involving the underlying bone is presented. Wide local excision of the scalp and full-thickness excision of the underlying calvarium and dura followed by reconstruction with latissimus dorsi free flap and skin graft was performed. Despite an initial negative frozen section of the margins, the final pathologic specimen showed microscopic involvement of the inferior margin. The positive margin was re-excised accomplished with the aid of mapping biopsies. This case demonstrates the typical nature of this rare tumor in terms of the difficulty of histologic diagnosis and surgical management.