A 68-year-old man presented with a recurrent lesion of his right shoulder. He had undergone surgery 4 months previously, which was interpreted as a capillary haemangioma in a local hospital. However, the lesion recurred and enlarged rapidly with exudation and bleeding (Fig. 1a). CT showed an irregular, poorly circumscribed soft tissue mass with heterogeneous enhancement, measuring 6.1 × 3.5 × 3.3 cm in size (Fig. 1b). Re-evaluation of H&E slides of the primary tumour revealed a primary cutaneous angiosarcoma with infiltration into the subcutaneous adipose tissue (Fig. 2).