Epithelioid angiosarcoma of the duodenum: a case report

Area of Science:

• Gastroenterology
• Surgical Oncology
• Pathology

Background:

• Angiosarcomas are rare vascular endothelial tumors.
• Gastrointestinal angiosarcomas, particularly in the duodenum, are exceptionally uncommon.
• Epithelioid angiosarcoma is a rare subtype with distinct cytomorphology.

Purpose of the Study:

• To report a case of duodenal epithelioid angiosarcoma.
• To describe the diagnostic and treatment approach for this rare entity.
• To emphasize the importance of immunohistochemistry in diagnosing angiosarcomas.

Main Methods:

• A 68-year-old male patient presented with anemia and hypotension.
• Diagnostic workup included esophagogastroduodenoscopy, biopsy, CT, and PET-CT.
• Treatment involved radical subtotal stomach-preserving pancreatoduodenectomy with lymphadenectomy.

Main Results:

• Histopathology and CD31 positivity confirmed duodenal epithelioid angiosarcoma.
• No lymph node or distant metastasis was detected preoperatively.
• The patient underwent successful surgical resection and had an uneventful recovery with no recurrence at 4 months.

Conclusions:

• Duodenal epithelioid angiosarcoma is a rare diagnosis presenting with potential gastrointestinal bleeding and anemia.
• Surgical resection is a primary treatment modality.
• Immunohistochemical analysis, especially CD31 staining, is vital for accurate diagnosis of epithelioid angiosarcomas.