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Anastomosing Hemangioma of the Ovary: A Clinicopathological Study of Six Cases with Stromal Luteinization

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Pathology & Oncology Research

Abstract

We report six cases of anastomosing hemangioma of the ovary. All lesions were unilateral and arose in 43 to 81 year old females. In all but one patient, the tumor was asymptomatic and represented incidental finding. The exception was a tumor associated with massive ascites and elevated CA 125. The tumors were, on cut section, spongy and dark violet in color. The size of tumors ranged from 0.5 to 3.5 cm. All lesions showed the same histological features and consisted of capillary sized anastomosing vessels with sinusoid-like pattern intermingled with sporadic medium sized vessels. Interestingly, in all cases there were areas of luteinized cells at the tumor periphery, which ranged from rare small nests to multiple and commonly confluent areas. In one tumor, components of mature adipose tissue were present. Immunohistochemically, all tumors were CD31 and CD34 positive. Other markers examined were negative, including; estrogen receptor, progesterone receptor, androgen receptor, and D2–40. Proliferative activity (Ki-67 index) was very low in all cases. Anastomosing hemangioma is a rare entity, only 8 lesions occurring in ovary has been described from its initial description in 2009. We report six additional cases with their clinicopathological correlation.

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References

  1. Montgomery E, Epstein JI (2009) Anastomosing hemangioma of the genitourinary tract: a lesion mimicking angiosarcoma. Am J Surg Pathol 33(9):1364–1369. doi:10.1097/PAS.0b013e3181ad30a7

    Article  PubMed  Google Scholar 

  2. Kryvenko ON, Gupta NS, Meier FA, Lee MW, Epstein JI (2011) Anastomosing hemangioma of the genitourinary system: eight cases in the kidney and ovary with immunohistochemical and ultrastructural analysis. Am J Clin Pathol 136(3):450–457. doi:10.1309/AJCPJPW34QCQYTMT

    Article  PubMed  Google Scholar 

  3. Omiyale AO (2015) Anastomosing hemangioma of the kidney: a literature review of a rare morphological variant of hemangioma. Ann Transl Med 3(11):151. doi:10.3978/j.issn.2305-5839.2015.06.16

    PubMed  PubMed Central  Google Scholar 

  4. Tao LL, Dai Y, Yin W, Chen J (2014) A case report of a renal anastomosing hemangioma and a literature review: an unusual variant histologically mimicking angiosarcoma. Diagn Pathol 9:159. doi:10.1186/s13000-014-0159-y

    Article  PubMed  PubMed Central  Google Scholar 

  5. John I, Folpe AL (2016) Anastomosing hemangiomas arising in unusual locations: a Clinicopathologic study of 17 soft tissue cases showing a predilection for the Paraspinal region. Am J Surg Pathol. doi:10.1097/PAS.0000000000000627

    PubMed  Google Scholar 

  6. Lin J, Bigge J, Ulbright TM, Montgomery E (2013) Anastomosing hemangioma of the liver and gastrointestinal tract: an unusual variant histologically mimicking angiosarcoma. Am J Surg Pathol 37(11):1761–1765. doi:10.1097/PAS.0b013e3182967e6c

    Article  PubMed  Google Scholar 

  7. O'Neill AC, Craig JW, Silverman SG, Alencar RO (2016) Anastomosing hemangiomas: locations of occurrence, imaging features, and diagnosis with percutaneous biopsy. Abdom Radiol (NY). doi:10.1007/s00261-016-0690-2

    Google Scholar 

  8. Metodiev D, Ivanova V, Omainikova B, Boshnakova T (2015) Ovarian anastomosing hemangioma with stromal luteinization: a case report. Akush Ginekol (Sofiia) 54(9):58–61

    CAS  Google Scholar 

  9. Akbulut M, Bir F, Colakoglu N, Soysal ME, Duzcan SE (2008) Ovarian hemangioma occurring synchronously with serous papillary carcinoma of the ovary and benign endometrial polyp. Ann Saudi Med 28(2):128–131

    Article  PubMed  Google Scholar 

  10. Anand MS, Shetty S, Mysorekar VV, Kumar RV (2012) Ovarian hemangioma with stromal luteinization and HCG-producing mononucleate and multinucleate cells of uncertain histogenesis: a rare co-existence with therapeutic dilemma. Indian J Pathol Microbiol 55(4):509–512. doi:10.4103/0377-4929.107793

    Article  PubMed  Google Scholar 

  11. Comunoglu C, Atasoy L, Baykal C (2010) Ovarian hemangioma occurring synchronously with contralateral mature cystic teratoma in an 81-year-old patient. Ups J Med Sci 115(4):297–299. doi:10.3109/03009734.2010.502602

    Article  PubMed  PubMed Central  Google Scholar 

  12. Correa-Rivas MS, Colon-Gonzalez G, Lugo-Vicente H (2003) Cavernous hemangioma presenting as a right adnexal mass in a child. P R Health Sci J 22(3):311–313

    PubMed  Google Scholar 

  13. Erdemoglu E, Kamaci M, Ozen S, Sahin HG, Kolusari A (2006) Ovarian hemangioma with elevated CA125 and ascites mimicking ovarian cancer. Eur J Gynaecol Oncol 27(2):195–196

    CAS  PubMed  Google Scholar 

  14. Gehrig PA, Fowler WC Jr, Lininger RA (2000) Ovarian capillary hemangioma presenting as an adnexal mass with massive ascites and elevated CA-125. Gynecol Oncol 76(1):130–132. doi:10.1006/gyno.1999.5648

    Article  CAS  PubMed  Google Scholar 

  15. Grant JW, Millward-Sadler GH (1986) Haemangioma of the ovary with associated endometrial hyperplasia. Case report Br J Obstet Gynaecol 93(11):1166–1168

    Article  CAS  PubMed  Google Scholar 

  16. Gucer F, Ozyilmaz F, Balkanli-Kaplan P, Mulayim N, Aydin O (2004) Ovarian hemangioma presenting with hyperandrogenism and endometrial cancer: a case report. Gynecol Oncol 94(3):821–824. doi:10.1016/j.ygyno.2004.06.021

    Article  PubMed  Google Scholar 

  17. Gunes HA, Egilmez R, Dulger M (1990) Ovarian haemangioma. Br J Clin Pract 44(12):734–735

    CAS  PubMed  Google Scholar 

  18. Gupta R, Singh S, Nigam S, Khurana N (2006) Benign vascular tumors of female genital tract. Int J Gynecol Cancer 16(3):1195–1200. doi:10.1111/j.1525-1438.2006.00523.x

    Article  CAS  PubMed  Google Scholar 

  19. Jurkovic I, Dudrikova K, Boor A (1999) Ovarian hemangioma. Cesk Patol 35(4):133–135

    CAS  PubMed  Google Scholar 

  20. Kaneta Y, Nishino R, Asaoka K, Toyoshima K, Ito K, Kitai H (2003) Ovarian hemangioma presenting as pseudo-Meigs' syndrome with elevated CA125. J Obstet Gynaecol Res 29(3):132–135

    Article  PubMed  Google Scholar 

  21. Kim SS, Han SE, Lee NK, Choi KU, Joo JK, Suh DS, Kim HY, Kim KH (2015) Ovarian cavernous hemangioma presenting as a large growing mass in a postmenopausal woman: a case report and review of the literature. J Menopausal Med 21(3):155–159. doi:10.6118/jmm.2015.21.3.155

    Article  PubMed  PubMed Central  Google Scholar 

  22. Koh LW, Sun YL, Koh PH, Chiu HY, Chen SY, Huang MH (2007) Ovarian capillary hemangioma presenting as pseudo-Meigs' syndrome: a case report. J Minim Invasive Gynecol 14(3):367–369. doi:10.1016/j.jmig.2006.10.030

    Article  PubMed  Google Scholar 

  23. Loverro G, Cormio G, Perlino E, Vicino M, Cazzolla A, Selvaggi L (1998) Transforming growth factor-beta1 in hemangioma of the ovary. Gynecol Obstet Investig 46(3):210–213

    Article  CAS  Google Scholar 

  24. McBurney RP, Trumbull M (1955) Hemangioma of the ovary with ascites. Miss Doct 32(10):271–274

    CAS  PubMed  Google Scholar 

  25. Miliaras D, Papaemmanouil S, Blatzas G (2001) Ovarian capillary hemangioma and stromal luteinization: a case study with hormonal receptor evaluation. Eur J Gynaecol Oncol 22(5):369–371

    CAS  PubMed  Google Scholar 

  26. Mirilas P, Georgiou G, Zevgolis G (1999) Ovarian cavernous hemangioma in an 8-year-old girl. Eur J Pediatr Surg 9(2):116–118. doi:10.1055/s-2008-1072225

    Article  CAS  PubMed  Google Scholar 

  27. Mitra B, Sengupta S, Rai A, Mehta J, Quader AR, Roy S, Borges A (2013) Ovarian haemangioma: A rare case report. Int J Surg Case Rep 4(11):981–984. doi:10.1016/j.ijscr.2013.07.029

    Article  PubMed  PubMed Central  Google Scholar 

  28. M'Pemba Loufoua-Lemay AB, Peko JF, Mbongo JA, Mokoko JC, Nzingoula S (2003) Ovarian torsion revealing an ovarian cavernous hemangioma in a child. Arch Pediatr 10(11):986–988

    Article  PubMed  Google Scholar 

  29. Ozana M, Formanek P, Sula F, Silhan J (1994) Ovarian hemangioma with torsion. Ceska Gynekol 59(1):18–20

    CAS  PubMed  Google Scholar 

  30. Pethe VV, Chitale SV, Godbole RN, Bidaye SV (1991) Hemangioma of the ovary--a case report and review of literature. Indian J Pathol Microbiol 34(4):290–292

    CAS  PubMed  Google Scholar 

  31. Rivasi F, Philippe E, Walter P, de Marco L, Ludwig L (1996) Ovarian angioma. Report of 3 asymptomatic cases. Ann Pathol 16(6):439–441

    CAS  PubMed  Google Scholar 

  32. Savargaonkar PR, Wells S, Graham I, Buckley CH (1994) Ovarian haemangiomas and stromal luteinization. Histopathology 25(2):185–188

    Article  CAS  PubMed  Google Scholar 

  33. Schoolmeester JK, Greipp PT, Keeney GL, Soslow RA (2015) Ovarian hemangiomas do not harbor EWSR1 rearrangements: Clinicopathologic characterization of 10 cases. Int J Gynecol Pathol 34(5):437–444. doi:10.1097/PGP.0000000000000171

    Article  CAS  PubMed  Google Scholar 

  34. Tran TA, Pernicone P (2012) Anastomosing hemangioma with fatty changes of the genitourinary tract: a lesion mimicking angiomyolipoma. Cent European J Urol 65(1):40–42. doi:10.5173/ceju.2012.01.art13

    Article  PubMed  PubMed Central  Google Scholar 

  35. Uppal S, Heller DS, Majmudar B (2004) Ovarian hemangioma--report of three cases and review of the literature. Arch Gynecol Obstet 270(1):1–5. doi:10.1007/s00404-003-0584-8

    Article  PubMed  Google Scholar 

  36. Yamawaki T, Hirai Y, Takeshima N, Hasumi K (1996) Ovarian hemangioma associated with concomitant stromal luteinization and ascites. Gynecol Oncol 61(3):438–441. doi:10.1006/gyno.1996.0170

    Article  CAS  PubMed  Google Scholar 

  37. Ziari K, Alizadeh K (2016) Ovarian hemangioma: a rare case report and review of the literature. Iran J Pathol 11(1):61–65

    PubMed  PubMed Central  Google Scholar 

  38. Akbulut M, Zekioglu O, Terek MC, Ozdemir N (2009) Florid vascular proliferation in mature cystic teratoma of the ovary: case report and review of the literature. Tumori 95(1):104–107

    PubMed  Google Scholar 

  39. Baker PM, Rosai J, Young RH (2002) Ovarian teratomas with florid benign vascular proliferation: a distinctive finding associated with the neural component of teratomas that may be confused with a vascular neoplasm. Int J Gynecol Pathol 21(1):16–21

    Article  PubMed  Google Scholar 

  40. Itoh H, Wada T, Michikata K, Sato Y, Seguchi T, Akiyama Y, Kataoka H (2004) Ovarian teratoma showing a predominant hemangiomatous element with stromal luteinization: report of a case and review of the literature. Pathol Int 54(4):279–283. doi:10.1111/j.1440-1827.2004.01621.x

    Article  PubMed  Google Scholar 

  41. Pongsuvareeyakul T, Settakorn J, Khorana J, Khunamornpong S (2015) Ovarian teratoma with predominant hemangiomatous component in early childhood. J Pediatr Adolesc Gynecol 28(1):e1–e3. doi:10.1016/j.jpag.2014.02.013

    Article  PubMed  Google Scholar 

  42. Illueca C, Machado I, Garcia A, Covisa A, Morales J, Cruz J, Traves V, Almenar S (2011) Uncommon vascular tumor of the ovary. Primary ovarian epithelioid hemangioendothelioma or vascular sarcomatous transformation in ovarian germ cell tumor? Arch Gynecol Obstet 284(6):1589–1591. doi:10.1007/s00404-011-2036-1

    Article  PubMed  Google Scholar 

  43. Prus D, Rosenberg AE, Blumenfeld A, Udassin R, Ne'eman Z, Young RH, Ariel I (1997) Infantile hemangioendothelioma of the ovary: a monodermal teratoma or a neoplasm of ovarian somatic cells? Am J Surg Pathol 21(10):1231–1235

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

This work was supported by Ministry of Health, Czech Republic (Project RVO 64165), by Charles University in Prague (Project PRVOUK-P27/LF1/1, PRVOUK P37/11, UNCE 204024, and SVV UK 260256/2016), BBMRI_CZ LM2015089 and BBMRI_CZ LM2010004, and by OPPK (Research Laboratory of Tumor Diseases, CZ.2.16/3.1.00/24509).

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Authors and Affiliations

  1. Department of Pathology, First Faculty of Medicine Charles University and General University Hospital in Prague, Studnickova 2, 12800, Prague 2, Czech Republic

    Pavel Dundr, Kristýna Němejcová, Helena Skálová, Lenka Bauerová & Radoslav Matěj

  2. The Fingerland Department of Pathology, Charles University, Faculty of Medicine and University Hospital Hradec Kralove, Hradec Kralove, Czech Republic

    Jan Laco

  3. Department of Pathology and Molecular Medicine, Thomayer Hospital, Prague, Czech Republic

    Radoslav Matěj

  4. Gynecologic Oncology Center, Department of Obstetrics and Gynecology, First Faculty of Medicine Charles University and General University Hospital in Prague, Prague, Czech Republic

    Daniela Fischerová

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  1. Pavel Dundr
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Correspondence to Pavel Dundr.

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Part of this work was presented on 27th European Congress of Pathology, Belgrad, Serbia, 5–9 September 2015.

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Dundr, P., Němejcová, K., Laco, J. et al. Anastomosing Hemangioma of the Ovary: A Clinicopathological Study of Six Cases with Stromal Luteinization. Pathol. Oncol. Res. 23, 717–722 (2017). https://doi.org/10.1007/s12253-016-0186-y

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