[Primary duodenal epithelioid angiosarcoma:a case report]

Area of Science:

• Gastroenterology
• Surgical Oncology
• Pathology

Background:

• Submucosal duodenal lesions can present with gastrointestinal bleeding.
• Accurate diagnosis of rare tumors is crucial for appropriate management.
• Epithelioid angiosarcoma is an uncommon vascular tumor with potential for aggressive behavior.

Purpose of the Study:

• To report a case of primary duodenal epithelioid angiosarcoma.
• To discuss the diagnostic challenges and management of this rare entity.

Main Methods:

• A case study of a 70-year-old male patient presenting with bloody stool.
• Diagnostic procedures included upper gastrointestinal endoscopy and endoscopic ultrasonography (EUS).
• Histopathological analysis and EUS-guided tissue acquisition were performed, followed by pancreaticoduodenectomy.

Main Results:

• Endoscopy revealed active bleeding from a duodenal submucosal lesion.
• Initial biopsy showed non-specific inflammatory changes and necrosis.
• EUS identified a 35-mm hypoechoic submucosal lesion, with tissue acquisition suggesting a poorly differentiated tumor.
• Final histopathological diagnosis after pancreaticoduodenectomy was primary duodenal epithelioid angiosarcoma.

Conclusions:

• Primary duodenal epithelioid angiosarcoma is a rare diagnosis that can mimic other gastrointestinal pathologies.
• EUS-guided tissue acquisition may improve diagnostic yield in challenging cases.
• Surgical resection, such as pancreaticoduodenectomy, is often necessary for definitive diagnosis and treatment.