We present an 85-year-old female patient with angiosarcoma of the cecum. The patient was admitted to our hospital with rectorrhagia. On admission she presented hypotension and tachycardia and physical examination showed mucocutaneous pallor and abdominal distension. Rectal examination showed bright red blood without identifying any tumour. A blood test showed a haemoglobin of 4.3 g/dl and a lower gastrointestinal endoscopy was performed, identifying a 1 cm reddish mass in the cecum with active bleeding, which was initially controlled with haemostatic clips after biopsies had been taken. Twelve hours later the patient presented with a new episode of gastrointestinal bleeding with hypotension and an urgent laparoscopic right hemicolectomy was performed. The patient was discharged on postoperative day 5. The extension study performed after surgery was negative.
On gross examination, the cecum contained a 2 cm exophytic ulcer. Microscopic analysis showed multiple anastomotic vascular channels dissecting the collagen and smooth muscle laminae down to the lamina propria and muscularis propria. Immunohistochemistry showed high reactivity of tumour cells to CD31 and vimentin. Staining for CD34, cytokeratin 20 and cytokeratin AE1-3 was negative. Based on these results, a diagnosis of epithelioid angiosarcoma of the colon was made. The margins were free of tumour as were the 12 lymph nodes analysed. The patient did not receive adjuvant treatment and at subsequent follow-up she is still alive and without evidence of disease two years after surgery.

