Published online Aug 7, 2020. doi: 10.3748/wjg.v26.i29.4372
Peer-review started: April 7, 2020
First decision: April 29, 2020
Revised: May 9, 2020
Accepted: July 15, 2020
Article in press: July 15, 2020
Published online: August 7, 2020
Processing time: 122 Days and 2.4 Hours
Epithelioid angiosarcoma is a vascular neoplasm that is among the most aggressive subtypes of sarcomas. Its involvement in the gastrointestinal tract is rare. We here report a case of multifocal gastrointestinal epithelioid angiosarcomas presenting with gastrointestinal bleeding.
A 77-year-old woman was admitted because of melena and dizziness for three months. Gastroscopy and colonoscopy were performed, revealing a centrally ulcerated hemorrhagic polypoid lesion in the gastric body and multiple polypoid lesions with blood clots and hemorrhagic tendency in the colon. Histopathological examination of routine endoscopic biopsy samples showed inflammation in the gastric mucosa and tubular adenomas in the colon. The polypoid lesions were removed by endoscopic mucosal resection. Immunohistochemistry suggested a final diagnosis of epithelioid angiosarcomas. The patient refused chemotherapy and died after three months.
Epithelioid angiosarcomas are characterized by highly vascular nature and tendency to cause gastrointestinal bleeding. Efforts to obtain histological findings using endoscopic mucosal resection are of great importance.
Core tip: Gastrointestinal epithelioid angiosarcoma is extremely rare, which is only described in individual case reports and case series. Most reported cases appeared as centrally ulcerated, hemorrhagic, highly erythematous or purpuric nodules. Histopathology is the golden standard for diagnosis. Endoscopic biopsy often obtains insufficient specimens, while endoscopic mucosal resection of suspected lesions is satisfactory for histopathological examination. We here report a case of gastrointestinal bleeding which was finally diagnosed as multifocal epithelioid angiosarcomas in the gastrointestinal tract.