Obscure gastrointestinal bleeding due to multifocal intestinal angiosarcoma.

Area of Science:

• Oncology
• Gastroenterology
• Pathology

Background:

• Intestinal angiosarcomas are exceptionally rare and aggressive vascular tumors.
• Few cases are documented in medical literature, making diagnosis challenging.
• These tumors often present with nonspecific symptoms, complicating early detection.

Purpose of the Study:

• To report a rare case of intestinal angiosarcoma.
• To discuss the diagnostic challenges and potential secondary origins of intestinal angiosarcoma.
• To highlight the importance of considering radiation-induced angiosarcoma in patients with a history of pelvic radiotherapy.

Main Methods:

• A case report of a 45-year-old male with intermittent gastrointestinal bleeding.
• Patient had a history of pelvic radiotherapy ten years prior.
• Diagnosis confirmed via histopathology showing high-grade epithelioid angiosarcoma with specific markers (CD31, CKAE 1/AE3, factor VIII).

Main Results:

• The patient presented with melena, weight loss, and hemodynamic instability due to uncontrolled bleeding.
• Histopathology revealed multifocal high-grade epithelioid angiosarcoma.
• The tumor exhibited reactivity for CD31, keratins CKAE 1/AE3, and factor VIII, consistent with angiosarcoma.

Conclusions:

• Intestinal angiosarcomas are aggressive with high metastatic potential.
• Diagnosis is difficult due to nonspecific clinical and histopathological findings.
• Secondary intestinal angiosarcoma following radiation therapy is suspected in this case, necessitating clinical vigilance.