A 49-year-old male patient was admitted to the Hematology Department with a diagnosis of probable non-Hodgkin lymphoma.
The patient reported a foreign body sensation of a month and a half of evolution, as well as a slow growth tumor in the upper abdomen, accompanied by asthenia and adynamia.
Physical examination revealed dyscalculia and abdominal pain, as well as a hard, painless, lobulated surface that covered the left hemiabdomen.
Cervical lymphadenopathy measuring an average of 1 cm was observed. With the clinical suspicion of lymphoma, a lymph node biopsy was performed, which was reported as mixed hyperplasia.
Abdominal CT reported an abdominal tumor extending from the left infradiaphragmatic region to the pelvic hollow.
The liver showed areas with decreased density and heterogeneous contrast uptake.
Sphincterectomy was performed, measuring 27 x 22 10 cm. The tapered surface was opaque and thickened.
At cutting areas were observed white gray, fibrous appearance and irregular edges, alternating with hemorrhagic zones and spongy aspect.
Microscopic examination revealed malignant vascular neoplasm with several growth patterns.
The best differentiated areas were constituted by vascular spaces dilated, in the form of «bee-panal» and the cells that regenerated them lacked atypia and pleomorphism.
Alternating with these areas hypercellular areas with solid growth pattern and formation of cracks and vascular channels were observed.
Immunohistochemistry was performed with the standard method streptoavidin-biotin-peroxidae, resulting positive angiosarcoma cells to vimentin and CD34, which confirmed the diagnosis.
At diagnosis, liver metastases were documented.
Later, he developed metastases in lung and bone, being considered out of oncological treatment.
Finally, at 15 months of follow-up the patient died due to tumor activity.
