Cutaneous angiosarcoma metastatic to small bowel with nodal involvement
Vidya A Fleetwood1, Jamie C Harris1, Minh B Luu1
1Department of General Surgery, Rush University Medical Center, Chicago, Illinois, USA.
Gastroenterology and Hepatology From Bed to Bench
|November 30, 2016
Summary
This case study highlights a rare instance of angiosarcoma metastasizing to the small bowel with lymph node involvement. Early diagnosis and laparoscopic resection are crucial for managing this aggressive cancer.
Area of Science:
- Oncology
- Surgical Pathology
Background:
- Angiosarcoma is a rare soft tissue sarcoma with a poor prognosis, often presenting on the head and neck.
- Risk factors include lymphedema, chemical exposures, and genetic predispositions.
Observation:
- A 77-year-old male with metastatic scalp angiosarcoma presented with severe gastrointestinal bleeding due to a jejunal mass.
- Capsule endoscopy revealed the jejunal mass, which was surgically resected laparoscopically.
- Pathology confirmed a high-grade metastatic angiosarcoma with lymph node involvement.
Findings:
- Metastasis of angiosarcoma to the small bowel is uncommon, and nodal involvement is exceptionally rare.
- This case represents the first documented instance of angiosarcoma with nodal involvement in the small bowel presenting at a resectable stage.
- The tumor measured 6.8cm, had negative margins after resection, and was high-grade.
Implications:
- A high index of suspicion for metastatic angiosarcoma is essential in patients with gastrointestinal symptoms and a history of the disease.
- Laparoscopic-assisted resection is a viable and safe surgical option for small bowel angiosarcoma.
- Early detection and intervention can improve outcomes for this rare presentation of angiosarcoma.
