J Korean Soc Radiol.  2022 Mar;83(2):432-438. 10.3348/jksr.2021.0064.

Primary Colonic Epithelioid Angiosarcoma with Hepatic Metastasis: A Case Report

• Lim J
• Hong SS
• Hwang J
• Kim Hj
• Jin SY

• KMID: 2527786
• DOI: http://doi.org/10.3348/jksr.2021.0064

Abstract

Colonic angiosarcoma is an extremely rare and aggressive malignant tumor with poor prognosis. We report a case of colonic epithelioid angiosarcoma with colonic obstruction and rapidly progressive hepatic metastasis in a 44-year-old female. Abdominal CT revealed a heterogeneously enhancing irregular mass in the ascending colon, causing proximal bowel distension. The patient underwent surgery, and histopathological examination revealed a poorly differentiated carcinoma. A follow-up liver dynamic MRI after 4 months revealed newly developed diffusely scattered numerous small nodules in both hepatic lobes with peripheral and nodular marked arterial hyperenhancement, raising the suspicion of hepatic angiosarcoma. A pathologic second opinion was obtained, and additional immunohistochemistry revealed colonic epithelioid angiosarcoma. The patient showed progressive hepatic metastasis on follow-up abdominal CT after 6 months and died 8 months after initial diagnosis. We describe an educational case of colonic angiosarcoma, a rare malignant tumor, with rapidly progressive hepatic metastasis that showed radiologic findings suggestive of angiosarcoma and enabled a re-diagnosis for proper treatment and prognosis prediction.

Keyword

Angiosarcoma; Colonic Neoplasms; Neoplasm Metastasis; Intestinal Obstruction; Multidetector Computed; Tomography; Magnetic Resonance Imaging