Approximately 50% of cASs occur in the head and neck, especially on the skull of the elderly, and are aggressive malignant tumors with poor prognosis.[1,6] Recently, several molecules, such as FOXM1, HSP90, KCa3.1, miR-497-5p, miR210, and survivin, were identified as potential markers and therapeutic targets for angiosarcoma.[7] In the current report, we presented a case of cAS of the thumb that expressed PD-1, PD-L1, NY-ESO, and MAGE-A4. The gene discussed is MAGEA4; the disease is cancer.