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Long-term hemodialysis may be associated with multicentric GI angiosarcoma; this case leaves open causality and requires confirmation.
A case of multicentric gastrointestinal angiosarcoma suffering from severe melena is presented. Endoscopical examination revealed two polyps in the stomach and duodenum. Histological examination showed angiosarcoma. Although a gastroduodenectomy was performed, severe melena continued, and the patient developed respiratory failure and died. At autopsy, multiple hemorrhagic tumors were present from the duodenum to the cecum. Histologically the tumors demonstrated vasoformative structure and were immunohistochemically positive for von Willebrand factor (factor VIII related antigen), CD34, and CD31. Numerous metastases were found in various organs, including the lungs, bones, liver, gall-bladder, and lymph nodes. The patient had received hemodialysis for 21 years due to chronic renal failure. Long-term dialysis had been associated with various malignancies. Multicentric development of angiosarcoma in the present case may also be related to long-term dialysis.
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Usuda et al. (1997) studied this question.
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