Malignant intravascular papillary angioendothelioma is a rare vascular tumour first described by Dabska. This lesion more often seen at childhood raises in skin or subcutis with a low grade of malignancy. This case is a woman at the age of 65 years. She reported to the clinic with purple, nodular, tender diffuse lesions on the skin of the lower abdomen and bilateral lower extremity oedema. Diagnostic survey revealed paraaortic, obturatory and inguinal lymph node enlargements. Skin and inguinal lymph node biopsies were performed. Skin biopsy material studied under light microscope revealed glomeruli like papillary structures projecting into the vascular spaces. The lymph node contained metastatic cells. By ultrastructural study pinositic vesicules, rare Weipel-Palade bodies and vascular structures lined by endothelial cells containing perinuclear mikrofilaments were diagnosed. The patient died after a short course during which the lymph node metastases disseminated.