AN AUTOPSY CASE OF ANGIOSARCOMA WITH METASTASES IN THE ESOPHAGUS, STOMACH AND COLON

Abstract

An autopsy case of angiosarcoma (suspicous of gingival origin) with metastases in the esophagus, stomach, sigmoid colon and other organs was presented. A 72-year-old male consulted a dentist complaining of pain in the left mandibular region. After extraction of teeth in this region, there was formed a nonhealing gingival ulcer with contact bleeding. Then, the patient was admitted to our hospital and received radiologic and endoscopic examinations of the stomach because of severe anemia (Table 1). X-ray photographs and endoscopic view revealed an elevated lesion (Borrmann, type II-like), ca. 2.5×2 cm in size at the gastric body along the lesser curvature (Figure 3, 4). After 50 hospital days, hemoptysis and respiratory distress appeared, and the patient died of respiratory failure at the 81st day. In this case, gingival and gastric biopsies were done. However, both of the examina-tions did not give the correct diagnosis, so that the tumor tissues in the biopsy specimens as well as those in the autopsy organs were histopathologically and immunohistologically reexamined. The tumor consisted predominantly of non-specif iable, undifferentiated components in both the gingival and metastatic lesions (Figure 1-a, 5), although it contained some parts that formed irregular vascular channels and showed positive immunostaining for the Factor VIII-related antigen by the peroxidase-anti-peroxidase method (Figure 10, 11). Angiosarcoma was reported to metastasize to the gastrointestinal (G-I) tract in a rare instance ; no further descriptions were found in the literature. Hence, radiologic and endoscopic appearance of the metastases in the G-I tract of this case was described here in detail and compared with that of another metastasic G-I tract tumors so far reported.