METASTATIC HEMANGIOSARCOMA OF STOMACH PROBABLY ORIGINATED FROM SPLEEN

Abstract

A 50-year-old man was admitted Fukushima Red Cross Hospital because of melena and general fatigue. Laboratory data revealed a disseminated intravascular coagulation (DIC) with severe anemia. X-ray examination of stomach showed multiple elevated lesions with ulcer on the greater curvature of the upper body. These findings were compatible with "bull's eye" sign which was radiologically characteristic for metastatic gastric tumor. Endoscopic examination revealed multiple reddish tumors with bleeding. Histopath-ological findings of the biopsied specimen of the tumor showed an infitlation of anaplastic cells in the submucosal layer. Computed tomography of his abdomen showed multiple nodular space occupying lesions (SQL) in the liver and diffuse large SOL in the spleen. Malignant tumor of the splenic origin was most suspicious, because the largest tumor located in the spleen. He died of pneumonia and necropsy of his hepatic and splenic tumor showed anaplastic cells similar to those in the gastric lesions. In some part of the splenic tumor, irregular vascular channels were noted. Immunohistological examination of the anaplastic cells in the splenic tumor showed positive stainning for Factor VIII-related antigen which is characteristic for hemangioma. Metastatic gastric hemangiosarcoma is very rare and gastrointestinal bleeding is characteristic for this disease since hemangioma is abundant in blood and is frequently complicated with DIC.