Rapidly progressive metastatic multicentric epithelioid angiosarcoma of the small bowel: a case report and a review of literature.
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.
Grewal
Jaspreet S
JS
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
Daniel
Amudha R M
AR
Carson
Erik J
EJ
Catanzaro
Andrew T
AT
Shehab
Thomas M
TM
Tworek
Joseph A
JA
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