Metastatic colon involvement from primary adrenal gland angiosarcoma: a case report.

Introduction: Angiosarcoma is a rare and aggressive malignancy accounting for 1-2% of soft tissue sarcomas. Primary adrenal angiosarcomas are exceptionally rare, with fewer than 60 cases reported.To our knowledge, this is the first documented case of an adrenal angiosarcoma presenting as a colonic metastasis.

Case report: A 68-year-old Caucasian North African woman with a history of adrenalectomy for a right adrenal tumor presented with gastrointestinal bleeding, and endoscopy revealed a hemorrhagic ulcerative lesion in the sigmoid colon. Histopathological examination revealed a malignant vascular tumor. Immunohistochemistry showed positivity for CD31, erythroblastosis virus E26 transforming sequence related gene, and pan-cytokeratin, consistent with angiosarcoma. In light of her history, a review of the adrenalectomy specimen confirmed the diagnosis of primary adrenal angiosarcoma.

Conclusion: This case underscores the necessity of thorough pathological evaluation, use of vascular markers, and interdisciplinary collaboration to improve diagnosis and management.