INUSUAL CAUSE OF UPPER GASTROINTESTINAL BLEEDING: METASTASIC RENAL ANGIOSARCOMA

Aims: Introduction:

Metastatic gastric tumours have low prevalence, 0.7% in autopsy, usually the primary neoplasms comes from breast, lungs and melanoma. (8 – 10) Some cases had been described of Kidney metastases, most of them coming from renal adenocarcinoma. Renal Angiosarcoma (AS) with gastric metastasis is not usual, therefore we decided to bring this clinical case.

Methods: Case report:

A 50 years old man with a left nephrectomy for renal angiosarcoma one month ago, went to emergency for black stools and asthenia, when patient arrived anaemia was diagnosed by blood tests, with 8 points less.

In view of findings, we did a gastroscopy and we found a 16 mm ulcerated node in greater curvature of gastric body, with a blood vessel and bleeding, we did adrenaline sclerosis and put hemoclips achieving the stopping of the bleeding some days.

We made a second look and the node wasn't healed, so a biopsy was taken for histogical and immnohistochemical analyses. As a results CD31, CD34, Vimentine and VIII factor were positive and an AS metastasis was confirmed.

The patient had a new anaemia episode, and he had a node resection by surgery. The diagnose of AS was verified by histological analyse of surgical specimen.

Results: Discussion:

AS is an infrequent malignant neoplasm, which results from endothelial cells proliferation in different organs, is more frequent in skin, liver, bone and breast (5). It has a reported 5-year survival of 13 – 32% in a 67 case report depending on the tumor size (6).

Furthermore, metastases are found mainly in lungs, liver, bones, lymph nodes, and in the spleen and peritoneum too (5, 7). It is obvious to think in a Metastasis with a neoplasm history before, but when its unusual could bring some diagnosis doubts in first time.