Colonic metastasis from subcutaneous angiosarcoma: A diagnostic dilemma

Area of Science:

• Oncology
• Gastroenterology
• Pathology

Background:

• Primary angiosarcoma is a rare, aggressive soft-tissue malignancy originating from endothelial cells.
• Intestinal angiosarcoma is exceptionally uncommon, often presenting diagnostic challenges and confusion with primary colonic neoplasms.
• Angiosarcoma commonly affects the skin and subcutaneous tissues of the extremities.

Purpose of the Study:

• To report an unusual case of epithelioid angiosarcoma of the sigmoid colon.
• To emphasize the diagnostic difficulties posed by intestinal angiosarcoma.
• To highlight the utility of histopathology and immunohistochemistry in diagnosing metastatic or primary intestinal angiosarcoma.

Main Methods:

• Case report of a 59-year-old male patient with sigmoid colon epithelioid angiosarcoma.
• Clinical presentation included occasional rectal bleeding.
• Retrospective review of histopathology and immunohistochemistry of both intestinal and thigh angiosarcoma specimens.

Main Results:

• The patient had a history of angiosarcoma of the subcutaneous tissue of the right thigh.
• The intestinal tumor was diagnosed as epithelioid angiosarcoma.
• Histopathology and immunohistochemistry confirmed the diagnosis and relationship between the two tumors.

Conclusions:

• Intestinal angiosarcoma, though rare, must be considered in the differential diagnosis of colonic tumors, particularly in patients with a history of angiosarcoma elsewhere.
• Accurate diagnosis relies on thorough histopathological examination and immunohistochemical analysis.
• This case underscores the importance of evaluating metastatic potential and primary origins in rare vascular malignancies.