Unexpected Discovery of Small Bowel Angiosarcoma Amidst the Management of Severe Polytrauma: A Case Report

Angiosarcoma is a rare, soft tissue tumor arising from lymphatic and vascular endothelial cells with high malignancy potential. While commonly observed in cutaneous and subcutaneous tissues, gastrointestinal subtypes are exceedingly rare. A 47-year-old male initially presented for the management of extensive burn injuries sustained in a motor vehicle collision. Throughout an extended hospital stay, he developed melanotic stools and progressive microcytic anemia. Following institutional burn protocol, the patient received multiple blood transfusions. Physical examination revealed a toxic appearance with abdominal distention. A push enteroscopy identified an ulcerated mass in the proximal jejunum. Surgical resection of the mass was performed, and pathological analysis confirmed the diagnosis of gastrointestinal angiosarcoma. The study concludes that patients presenting with unidentifiable melena and anemia after imaging and routine scopes should be considered for having a gastrointestinal lesion, including a gastrointestinal angiosarcoma, despite its rarity. Early recognition of such conditions may facilitate timely diagnosis and intervention, potentially improving survival outcomes. Furthermore, in the complexity of this case in relation to other existing medical conditions and traumatic injuries, weighing risk and benefit to tailor treatment including utilization of chemotherapy and radiation should be individualized.