Key result
A 77-year-old female presenting with recurring melena was diagnosed with an extremely rare colonic epithelioid angiosarcoma characterized by polypoid protrusions and distant metastases.
Why the study?
Angiosarcoma is highly invasive with a poor prognosis, and understanding its endoscopic characteristics will aid in early diagnosis and treatment.
Case Report (n=1)
No
Colorectal angiosarcoma is an extremely rare and highly malignant tumour that can present as colonic polyps, and understanding its endoscopic morphology aids in early diagnosis.
Answers are grounded in this paper and cite their sources.
May aid endoscopic recognition of rare gastric angiosarcoma; leaves open need for validation in larger series.
RATIONALE: Angiosarcoma is a highly invasive tumour with a low incidence rate but high rates of local recurrence and distant metastasis and a poor prognosis. Understanding the endoscopic characteristics of angiosarcoma will help with early diagnosis and treatment of this disease. PATIENT CONCERNS: The patient was a 77-year-old female who was admitted to the hospital due to recurring melena for 3 months. Outpatient gastroscopy showed that the patient had multiple gastric erosions. Colonoscopy revealed the presence of multiple protruding lesions in the colon and multiple rectal polyps. Pathological biopsy indicated that the patient had a tubular adenoma, which was removed by endoscopic resection. DIAGNOSES: Postsurgical pathologic assessment suggested that the histological subtype was epithelioid angiosarcoma. Positron emission tomography-computed tomography (PET-CT) revealed multiple metastases in the lymph nodes and bone. INTERVENTIONS: The patient underwent acid suppression to protect the stomach, fluid supplementation and red blood cell infusion, and subsequently, surgery, radiotherapy and chemotherapy were recommended. The patient's family refused further treatments for the patient and requested discharge. OUTCOMES: The patient refused further treatment and was not followed-up. LESSONS: Colorectal angiosarcoma is an extremely rare and highly malignant tumour, and understanding its endoscopic morphology will help aid in its diagnosis.
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Zhao et al. (2020) conducted a case report in Colonic epithelioid angiosarcoma (n=1). Endoscopic resection and supportive care was evaluated. A 77-year-old female presenting with recurring melena was diagnosed with an extremely rare colonic epithelioid angiosarcoma characterized by polypoid protrusions and distant metastases.
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