Unusual cause of small bowel perforation: metastasis of a subcutaneous angiosarcoma of the head

Ruffolo, Cesare; Angriman, Imerio; Montesco, Maria Cristina; Scarpa, Marco; Polese, Lino; Barollo, Michela; Pagano, Domenico; D’Amico, Davide

doi:10.1007/s00384-004-0684-3

Cited by 5 publications

(7 citation statements)

References 6 publications

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“…To date, only six cases of surgical resection of intestinal metastasis of angiosarcoma have been reported (Table 1 ) [ 3 , 6 – 10 ]. To the best of our knowledge, ours is the first case of intestinal perforation due to macroscopically indistinguishable metastasis of angiosarcoma (Table 1 ).…”

Section: Case Presentationmentioning

confidence: 99%

“…Hemorrhage occurred in four cases (67 %), but peritonitis occurred in only two cases (33 %) (Table 1 ). Ruffolo et al [ 3 ] reported a case of intestinal perforation due to invasion of an ulcerated tumor through all layers of the small intestine. In the present case, no visible or palpable ulcerative changes were present on the mucosal or serosal surface of the intestine at or around the perforation site.…”

Section: Case Presentationmentioning

confidence: 99%

“…The prognosis of this tumor is poor [ 1 ]. The most common sites of recurrence are the regional lymph nodes and lungs, followed by the liver and spleen [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

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Small bowel perforation due to indistinguishable metastasis of angiosarcoma: case report and brief literature review

et al. 2016

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Intestinal metastasis of angiosarcoma is extremely rare. We herein report a case of intestinal perforation due to intestinal metastasis of angiosarcoma. The patient was a 72-year-old Japanese man with multiple recurrent angiosarcomas of the scalp. He developed acute abdominal pain with guarding, and we performed an emergency exploratory laparotomy. An intestinal perforation was found 80 cm from the ligament of Treitz, and partial jejunectomy was successfully performed. Macroscopic inspection revealed no obvious injury, ulcer, or tumor at or around the perforation site. Pathological examination revealed angiosarcoma cells penetrating through all layers of the jejunum at the site of intestinal perforation. This is the first reported case of intestinal perforation caused by indistinguishable intestinal metastasis of angiosarcoma. This case emphasizes intestinal metastasis of angiosarcoma as a possible cause of small bowel perforation in patients with advanced angiosarcoma, even when no visible tumor is present during surgery.

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Section: Case Presentationmentioning

confidence: 99%

Section: Case Presentationmentioning

confidence: 99%

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Small bowel perforation due to indistinguishable metastasis of angiosarcoma: case report and brief literature review

et al. 2016

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“…Previously published sporadic case reports indicate that small bowel is a rare site of metastatic localization of hepatic angiosarcoma 9, 10 originating from subcutaneous angiosarcoma of the head 11 , aortic endothelioma [12][13][14] , thyroid gland 15 and spleen 16 . Multifocal epitheloid angiosarcoma of the small intestine originating from the skin in one and of unclear origin in the other patient was also described 17,18 .…”

Section: Discussionmentioning

confidence: 99%

Melena as a first sign of metastatic hepatic angiosarcoma: A case report

Sokic-Milutinovic¹,

Toncev²,

Glišić³

et al. 2019

VOJNOSANIT PREGL

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Introduction. Angiosarcomas are malignant tumors of vascular endothelium that may arise from different locations. Although primary hepatic angiosarcoma accounts for only 1.8% of primary liver tumors, it is the most common malignant mesenchymal tumor of the liver. We report a case of primary hepatic angiosarcoma with melena as an unusual initial manifestation of this extremely rare tumor. Case report. Forty-four-years old patient with melena was referred to our Clinic because melena was not resolved after repeated argon plasma coagulation of bleeding lesions during esophagogastroduodenoscopy in the regional hospital. Abdominal ultrasound and multislice computed tomography (MSCT) revealed enlarged liver, with focal lesion 6 cm in diameter localized in the left lobe with multiple satellite lesions in both liver lobes, enlarged spleen and extremely dilated and long umbilical vein. Double-balloon enteroscopy and video capsule endoscopy detected the multiple bleeding vascular lesions in the small bowel. Histopathological examination and immunohistochemistry of the small bowel lesions revealed malignant mesenchymal proliferation with vascular/endothelium differentiation of neoplastic cells. The patient was diagnosed with metastatic angiosarcoma probably of hepatic origin with metastasis in the small bowel, that caused melena, and in the lumbar spine, causing back pain. Conclusion. Rare causes of melena include bleeding from primary or metastatic hemangiosarcoma localized in the gastrointestinal tract, especially small bowel.

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“…The first gastrointestinal angiosarcoma reported by Langhans T in 1879 was found in the spleen [8]. There have been a limited number of cases reported since its initial discovery [9-13]. …”

Section: Introductionmentioning

confidence: 99%

Clinical Characteristics and Prognostic Factors of Small Intestine Angiosarcoma: a Retrospective Clinical Analysis of 66 Cases

Ouyang

Xiao

et al. 2017

Cell Physiol Biochem

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Background/Aims: Primary angiosarcoma of the small intestine is a rare neoplasia, and there are limited data from systematic analyses. The aim of this study is to describe the clinical and pathological characteristics in addition to the prognostic factors for this rare neoplasia. Methods: We retrospectively collected the clinical records and prognostic information of 66 patients with small intestine angiosarcoma reported between 1970 and 2017. We used the Chi-square test, the log-rank test, and Cox regression analyses to evaluate the data. Results: There were 66 patients diagnosed with small intestine angiosarcoma. The onset age ranged from 24–92 years old. There were 24 patients diagnosed before the year 2000, and 42 patients were diagnosed after 2000. The data indicated that 49 cases were diagnosed as primary disease, and the remaining 15 cases were secondary disease. The main clinical symptoms were nonspecific and included gastrointestinal (GI) bleeding and abdominal pain. Additionally, we found multi-center foci were one of the characteristics of this disease. Radiation-induced small intestine angiosarcoma (RSIA) is a special type of disease with a similar prognosis. This type was more frequent in females and decreased after the year 2000. We also found that GI bleeding was less common in RSIA cases. The log-rank test results revealed that old-age, poor differentiation, and GI bleeding were associated with worse prognosis. Surgical treatment showed a trend toward a prolonged survival time. However, the result was not statistically significant. Our results show treatment with adjuvant therapy improved prognosis. The multivariate Cox analysis demonstrated adjuvant therapy was an independent indicator of a favorable outcome in small intestine angiosarcoma patients. Conclusion: Pay attention to the unexplained gastrointestinal bleeding could lead to a faster diagnosis and control of small intestine angiosarcoma. Furthermore, treatments including adjuvant therapy can effectively improve the prognosis.

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Unusual cause of small bowel perforation: metastasis of a subcutaneous angiosarcoma of the head

Cited by 5 publications

References 6 publications

Small bowel perforation due to indistinguishable metastasis of angiosarcoma: case report and brief literature review

Small bowel perforation due to indistinguishable metastasis of angiosarcoma: case report and brief literature review

Melena as a first sign of metastatic hepatic angiosarcoma: A case report

Clinical Characteristics and Prognostic Factors of Small Intestine Angiosarcoma: a Retrospective Clinical Analysis of 66 Cases

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