title: Rapidly progressive metastatic multicentric epithelioid angiosarcoma of the small bowel: a case report and a review of literature.
abstract: BACKGROUND
  Angiosarcoma is a rare high-grade neoplasm that frequently involves the skin and subcutaneous tissue. Rarely, angiosarcoma can occur in the gastrointestinal tract where it frequently exhibits multicentric epithelioid morphology.
  
  
  METHODS
  We report a case of multicentric epithelioid angiosarcoma (EAS) of the small intestine in a 73-year-old male patient who presented with weakness and melena, and was found to have bleeding lesions in the small intestine on upper gastrointestinal endoscopy. In addition to this case, we extensively reviewed the clinical and pathological features of previously reported cases of angiosarcoma of the small intestine in the English literature since 1970.
  
  
  RESULTS
  Our patient presented with rare and aggressive EAS of the small intestine. Despite surgical resection of the lesions, the patient continued to worsen and developed rapidly progressive metastatic disease. He died within 4 months of the diagnosis.
  
  
  CONCLUSIONS
  Angiosarcoma, especially of the deep tissues and the gastrointestinal tract, is very aggressive and rapidly metastatic. The survival rate in these patients is extremely poor, and most patients die within 6 months to 1 year of the diagnosis. Treatment usually involves surgical resection of the bleeding lesions and frequent blood transfusions for symptom alleviation.
authors: Department of Internal Medicine, St. Joseph Mercy Hospital, Reichert Health Center, 5333 McAuley Drive, Suite 3009, Ann Arbor, MI 48106-0995, USA. grewalj@trinity-health.org
authors: Jaspreet S
authors: JS
authors: Grewal
authors: Amudha R M
authors: AR
authors: Daniel
authors: Erik J
authors: EJ
authors: Carson
authors: Andrew T
authors: AT
authors: Catanzaro
authors: Thomas M
authors: TM
authors: Shehab
authors: Joseph A
authors: JA
authors: Tworek
mesh_terms: D000008:Abdominal Neoplasms / Q000556:secondary; D034861:Abdominal Wall / Q000473:pathology; D000077:Acetabulum / Q000473:pathology; D000368:Aged; D016099:Endoscopy, Gastrointestinal; D017809:Fatal Outcome; D006394:Hemangiosarcoma / Q000473:pathology* / Q000556:secondary* / Q000601:surgery; D006801:Humans; D007414:Intestinal Neoplasms / Q000473:pathology* / Q000601:surgery; D007421:Intestine, Small / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D009959:Oropharyngeal Neoplasms / Q000556:secondary; D010386:Pelvic Neoplasms / Q000556:secondary; D016312:Treatment Refusal