Multiple Primary Angiosarcomas of the Colon

Area of Science:

• Oncology
• Pathology
• Gastroenterology

Background:

• Gastrointestinal angiosarcomas are rare malignancies, predominantly affecting the stomach and small intestine.
• Colorectal angiosarcomas are exceptionally uncommon, posing diagnostic challenges.

Observation:

• A 61-year-old male presented with fever and abdominal pain, initially treated for infection.
• Multislice computed tomography (MSCT) revealed soft tissue tumors, and colonoscopy identified an ulcerated sigmoid colon tumor.
• Initial biopsy suggested gastrointestinal stromal tumor (GIST), complicating the diagnosis.

Findings:

• Microscopic examination of the resected colon revealed four distinct angiosarcomas.
• Immunohistochemical staining confirmed the diagnosis, showing positivity for endothelial markers (ERG, CD31, CD34) and CD117.
• The patient experienced rapid decline and passed away from multiple organ failure.

Implications:

• Clinical and pathological diagnosis of colorectal angiosarcoma is difficult due to nonspecific symptoms and potential for misdiagnosis.
• Accurate diagnosis relies heavily on immunohistochemical analysis for endothelial markers.
• Late diagnosis and mismanagement contribute to poor patient outcomes.