Peer Review Report For: Case Report: Severe gastrointestinal bleeding revealing metastatic multifocal gastrointestinal angiosarcoma [version 2; peer review: 1 approved, 1 approved with reservations]

Résumé

Background: Angiosarcoma is a rare soft-tissue sarcoma that can arise in any soft-tissue structure or viscera. Only individual case reports and small series of gastrointestinal angiosarcoma have been reported in the literature. In this paper, we report the first African case of small intestine epithelioid angiosarcoma. Case report: Here, we present the case of a 66-year-old man who presented with melena and anemia. Physical examination showed the presence of two subcutaneous masses on the right and left flanks. Esophagogastroduodenoscopy, duodenoscopy and jejunoscopy revealed multiple purpuric and hemorrhagic nodules and masses, some of which were bleeding. Pathological study of the ampullary formation and of a subcutaneous nodule concluded to the diagnosis of epithelioid angiosarcoma. Blood transfusions and interventional endoscopy by argan plasma coagulation were required due to a continued drop in hemoglobin. A drop in hemoglobin persisted and the patient died within 10 days. Conclusions: Angiosarcoma has a very poor prognosis due to delayed prognosis and insufficient therapeutic management. Interventional endoscopy to control bleeding can be considered in localized forms. Chemotherapy may help to prolong survival in metastatic and disseminated angiosarcoma. Further studies should be conducted to improve the prognosis.

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