Berna SAVAŞ, Murat SÖNMEZER, Koray CEYHAN, Güldal YILMAZ, Sibel PERÇİNEL

Ovarian cavernous hemangioma: a case report and review of the literature with reference to controversial pathological diagnoses

Overin zengin bir vasküler desteği olmasına karşın kadın genital traktusun vasküler tümörleri özellikle overden köken alanları oldukça nadir görülmektedir. Semptomatik uterus leiomyomlarından dolayı total abdominal histerektomi ve sağ salpingoooforektomi yapılan 48 yaşındaki bir kadın hastanın sağ overindeki kavernoz hemanjiom olgusu bildirilmektedir. Laparotomide leiomyom ile uyumlu multipl uterus nodülü saptanmasına karşın sağ overde anlamlı bir patoloji izlenmemistir. Makroskopik olarak iki intramural leiomyom nodülü, bir korpus luteum kisti, bir kortikal kist, multipl korpora albikans ve bir paratubal kist gözlenmiştir. Mikroskopik inceleme, sağ overin korteks ve medullasında makroskopik olarak görülemeyen, lümenleri eritrosit ile dolu, ince duvarlı multipl vasküler yapıdan oluşan insidental bir kavernoz hemanjiomu ortaya çıkarmıştır. Bu vasküler yapıların CD31, CD34 ve factor VIII-related antigen ile kuvvetli immünreaktivite gösteren tek sıra basıklaşmış endotelyal hücrelerle döseli olduğu izlenmiştir.

Overyan kavernoz hemanjiom: tartışmalı patoloji ayırıcı tanıların referans alındığı literatür eşliğinde olgu sunumu

Vascular tumors of the female genital tract, especially those arising in the ovary, are very rare although the ovary has a rich vascular supply. We report a case of cavernous hemangioma of the right ovary in a 48-year-old woman who underwent total abdominal hysterectomy and right salpingo-oophorectomy for symptomatic uterine leiomyomas. At laparotomy, multiple uterine nodules consistent with leiomyomas were detected but the right ovary was unremarkable. Macroscopically, two intramural leiomyoma nodules, a corpus luteum cyst, a cortical cyst, multiple corpora albicans, and a paratubal cyst were observed. Microscopical examination revealed an incidental cavernous hemangioma, consisting of multiple thin-walled vascular channels, filled with red blood cells in the cortex and medulla of the right ovary, which had not been grossly appreciated. These vascular channels were lined by a single layer of flattened endothelial cells that showed strong immunoreactivity for CD31, CD34, and factor VIII-related antigen.

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1. Mirilas P, Georgiou G, Zevgolis G. Ovarian cavernous hemangioma in an 8-year-old girl. Eur J Pediatr Surg 1999; 9: 116-118.
2. Kaneta Y, Nishino R, Asaoka K, et al. Ovarian hemangioma presenting as pseudo- Meigs’ syndrome with elevated CA125. J Obstet Gynaecol Res 2003; 29: 132-135.
3. Gücer F, Özyılmaz F, Balkanlı-Kaplan P, et al. Ovarian hemangioma presenting with hyperandrogenism and endometrial cancer: a case report. Gynecol Oncol 2004; 94: 821-824.
4. Uppal S, Heller DS, Majmudar B. Ovarian hemangioma---report of three cases and review of the literature. Arch Gynecol Obstet 2004; 270: 1-5.
5. Gupta R, Singh S, Nigam S, et al. Benign vascular tumors of female genital tract. Int J Gynecol Cancer 2006; 16: 1195-1200.
6. Rodriguez MA. Hemangioma of the ovary in an 81 year old woman. South Med J 1979; 72: 503-504.
7. Pethe VV, Chitale SV, Godbole RN, et al. Hemangioma of the ovary – a case report and review of the literature. Indian J Pathol Microbiol 1991; 34: 290-292.
8. Gay RM, Janovski NA. Cavernous hemangioma of the ovary. Gynaecologia 1969; 168: 248-257.
9. Tanaka Y, Sasaki Y, Tachibana K, et al. Gonadal mixed germ cell tumour combined with a large hemangiomatous lesion in a patient with Turner’s syndrome and 45,X/46,X +mar karyotype (see comment). Arch Pathol Lab Med 1994; 118: 1135- 1138. Comment in Arch Pathol Lab Med 1995; 19: 992-993.
10. Gehrig PA, Fowler WC, Lininger RA. Ovarian capillary hemangioma presenting as an adnexal mass with massive ascites and elevated CA-125. Gynecol Oncol 2000; 76: 130-132.
11. Alvarez M, Cerezo L. Ovarian cavernous hemangioma. Arch Pathol Lab Med 1986;110: 77-78.
12. Carder PJ, Gouldesbrough DR. Ovarian hemangiomas and stromal luteinization. Correspondence. Histopathol 1995; 26: 585-586.
13. Grant JW, Millward-Sadler GH. Haemangioma of the ovary associated with endometrial hyperplasia---case report. Br J Obstet Gynaecol 1986; 193: 1166-1168.
14. Miliaras D, Papaemmanouil S, Blatzas G. Ovarian capillary hemangioma and stromal luteinization: a case study with hormonal receptor evaluation. Eur J Gynaecol Oncol 2001; 22: 369-371.
15. Savargaonkar PR, Wells S, Graham I, et al. Ovarian hemangiomas and stromal luteinization. Histopathol 1994; 25: 185-188.
16. Yamawaki T, Hirai Y, Takeshima N, et al. Ovarian hemangioma associated with concomitant stromal luteinization and ascites. Gynecol Oncol 1996; 61: 438-441.
17. Lawhead RA, Copeland LJ, Edwards CL. Bilateral ovarian hemangiomas associated with diffuse abdominopelvic hemangiomatosis. Obstet Gynecol 1985; 65: 597-599.
18. DiOrio J, Lowe LC. Hemangioma of the ovary in pregnancy. A case report. J Reprod Med 1980; 24: 232-234.
19. Kusum K, Aurora AL. Hemangioma of the ovary. J Indian Med Assoc 1980; 75: 201-202.
20. Clement PB: Histology of the ovary. In Sternberg SS: Histology for Pathologists. 2nd edition. Lippincott-Raven, Philadelphia, 1997, P: 929-959.
21. Feuerstein IM, Aronson BL, McCarthy EF. Bilateral ovarian cystic teratomata mimicking bilateral pure ovarian hemangiomata: case report. Int J Gynecol Pathol 1984; 3: 393-397.
22. Prus D, Rosenberg AE, Blumenfeld A, et al. Infantile hemangioendothelioma of the ovary: a monodermal teratoma or a neoplasm of ovarian somatic cells. Am J Surg Pathol 1997; 21: 1231-1235.