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rectal adenocarcinoma in January 2007. The patient underwent neoadjuvant radiochemotherapy followed by low anterior resection with total mesorectal excision. Histology showed foci of residual cancer tissue within the muscularis propria, and clear resection margins. Upon surveillance colonoscopy performed 3 years later, an irregular tumor mass was detected at the anastomosis, raising suspicion of a local cancer recurrence (●" Fig. 1). Magnetic resonance imaging showed an intrapelvic tumor (8 cm maximum diameter) diffusely infiltrating the bowel wall (●" Fig. 2). Histology revealed a malignant mesenchymal tumor with marked epithelioid cytomorphology and occasional cleft-like spaces, suggestive of vascular differentiation (●" Fig. 3). Diagnosis of angiosarcomawas confirmed by immunoreactivity for CD31, whereas markers of epithelial differentiation were negative. Angiosarcomas occur very rarely in the intestinal tract as either primary or metastatic malignancy [1]. In publications, intestinal angiosarcomas appear only in small series and as occasional case reports [1,2]. In only two patients, tumor occurrence was related to antecedent radiotherapy or chemoradiotherapy [3,4]. One case occurred 8 years after radiotherapy for prostate cancer [3], the other, similar to our case, about 3 years after radiochemotherapy for rectal cancer [4]. Although ionizing radiation is one of the few known risk factors for angiosarcoma, a large-cohort study on more than 3 cancer patients recently questioned this association [5]. In general, intestinal angiosarcomas run a dismal clinical course with high risk of local tumor recurrence and propensity for widespread dissemination [1]. Upon endoscopy, they may easily be mistaken for an epithelial malignancy, especially when Angiosarcoma at the anastomotic site mimicking local recurrence of rectal adenocarcinoma