Abstract
Angiosarcoma is a rare disease and it extremely rarely involves the gastrointestinal tract. Here we report a very rare case of angiosarcoma presented with intestinal perforation. An 83-year-old man was referred to our hospital because of upper abdominal pain and was diagnosed with generalized peritonitis due to intestinal perforation. Then an emergency laparotomy was performed. Upon laparotomy, a tumor 2cm in diameter was present at the jejunum near the Treitz ligament, and the center of which had perforated. Similar gastrointestinal tumors were felt in the stomach, small intestine, and descending colon. We removed all lesions and reconstructed with the parts as possible as we could. The mucosa surface of the all resected tumors showed a type 2 tumor like appearance having a necrotic ulceration in the center of a brown bump. The immunohistochemical staining which were positive for factor VIII, CD31 and CD34 indicated the diagnosis of angiosarcoma. He was complicated by postoperative ileus and gastrointestinal bleeding, and finally died of respiratory failure resulting from pneumonia 47 days after the surgery. A biopsy of the forehead rash which has been presented since two years before was performed often surgery and offered a diagnosis of angiosarcoma. An autopsy revealed metastases to the lung lobes and liver. It would suggest that the primary angiosarcoma of the forehead rash had spread to the whole body.
