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Angiosarcomas are aggressive, malignant tumors of vascular or lymphatic origin with high potential to local and distant spread. Cutaneous invasion of internal tumors is rarely encountered in clinical practice. We report on a patient with vascular skin lesions over anterior chest which turned out to be incursion from chest wall angiosarcoma. Alongside the case report, literature on therapeutic arsenal of angiosarcoma is reviewed. Angiosarcoma of chest wall invading into the skin has never been reported in dermatological literature. This case is intriguing as the patient had symptomless progression of the malignancy despite aggressive invasion to overlying skin and metastasis to lungs and pleura. This impresses upon the crucial role of dermatologists in suspecting cutaneous lesions which may appear skin deep but are otherwise a silent sign of grave internal disease so that search of underlying condition is sought as soon as possible to achieve better patient outcome. So the dictum is “earlier the diagnosis, better the prognosis”

Primary angiosarcoma of chest wall inside out: A rare presentation