Gastrointestinal bleeding caused by jejunal angiosarcoma: A case report

doi:10.12998/wjcc.v8.i19.4565

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World Journal of Clinical Cases

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Case Report

World J Clin Cases. Oct 6, 2020; 8(19): 4565-4571
Published online Oct 6, 2020. doi: 10.12998/wjcc.v8.i19.4565

Gastrointestinal bleeding caused by jejunal angiosarcoma: A case report

Yang-Yang Hui, Lan-Ping Zhu, Bo Yang, Zi-Yue Zhang, Yu-Jie Zhang, Xin Chen, Bang-Mao Wang

Yang-Yang Hui, Lan-Ping Zhu, Bo Yang, Xin Chen, Bang-Mao Wang, Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China

Zi-Yue Zhang, Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin 300072, China

Yu-Jie Zhang, Department of Pathology, Tianjin Medical University General Hospital, Tianjin 300052, China

Author contributions: All authors have contributed significantly to and agree with the content of the manuscript; Hui YY and Zhu LP contributed to patient care, case presentation, and manuscript drafting; Yang B and Zhang ZY contributed to the collection of examination results and follow-up of the patient; Zhang YJ performed the histological examination and interpreted the immunostaining results; Wang BM and Chen X contributed to the conception and revision of the manuscript; all authors issued final approval for the version to be submitted.

Supported by Science and Technology Program of Tianjin, No. 19PTZWHZ00090 and No. 15ZXJZSY00020; National Natural Science Foundation of China, No. 81503019 and No. 81200261; Natural Science Foundation of Tianjin City, No. 18JCZDJC45200.

Informed consent statement: Written informed consent for publication of this report and any accompanying images was obtained from the patient's wife.

Conflict-of-interest statement: The authors declare no conflict of interest.

CARE Checklist (2016) statement: The manuscript was written and revised in accordance with the CARE Checklist -2016.

Corresponding author: Xin Chen, MD, PhD, Associate Professor, Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, No. 154 Anshan Road, Tianjin 300052, China. xchen03@tmu.edu.cn

Received: May 6, 2020
Peer-review started: May 6, 2020
First decision: May 15, 2020
Revised: May 24, 2020
Accepted: August 26, 2020
Article in press: August 26, 2020
Published online: October 6, 2020
Processing time: 144 Days and 12.6 Hours

Abstract

BACKGROUND

Angiosarcoma is a rare disease with a poor prognosis. Its occurrence in the small intestine is low, and gastrointestinal bleeding caused by small intestinal angiosarcoma is unusual.

CASE SUMMARY

Here, we report the case of a 57-year-old man who presented with hematochezia for 1 mo. The patient had a medical history of chronic viral hepatitis B for 15 years. The causes of gastrointestinal bleeding were initially diagnosed as esophagogastric variceal bleeding or portal hypertensive gastropathy before endoscopy. However, after a complicated diagnostic and therapeutic process, including gastroendoscopy, colonoscopy, contrast-enhanced computed tomographic (CT), positron emission computed tomography/CT, capsule endoscopy, and pathological and immunohistochemical examinations, small intestinal angiosarcoma was diagnosed. Arrest of bleeding was achieved after surgical treatment. Furthermore, the patient had lung cancer with bone and adrenal metastases. At the follow-up 10 mo after the operation, the patient was alive.

CONCLUSION

Gastroenterologists should maintain strong vigilance to small intestinal angiosarcoma, which is necessary for the early identification of this infrequent but fatal disease.

Keywords: Small intestine; Angiosarcoma; Gastrointestinal bleeding; Case report; Diagnosis; Prognosis

Core Tip: Angiosarcoma is a rare disease with a poor prognosis. Its occurrence in the small intestine is low, and gastrointestinal bleeding caused by small intestinal angiosarcoma is unusual. We report a rare case of small intestinal angiosarcoma that caused gastrointestinal hemorrhage in a patient with a history of chronic hepatitis B and lung cancer with bone and adrenal metastases. The diagnosis of a small intestinal angiosarcoma was made by pathological and immunohistochemical examinations and arrest of bleeding was achieved after surgical treatment. Gastroenterologists should maintain strong vigilance to small intestinal angiosarcoma, which is necessary for the early identification of this infrequent but fatal disease.