Ovarian hemangiomas with associated hilus cell hyperplasia

Background:

Vascular tumors are rare in the female genital tract, particularly in the ovary. Lower than 50 cases of true ovarian hemangiomas have been reported (Uppal et al. 2004).

Methods: Here we report three cases.

Results:

The first consisted of a 66-year old woman with the clinical diagnoses of an ovarian cysts, the endometrium was unremarkable. The resection specimen showed a heavily regressive changed luteinised cyst and at hilus of the ovary a capillary hemangioma with associated hilus cell proliferation of 1.4 cm in largest dimension. The second represented in a 81-year old women with an hysterectomy 5 years before because of simple endometrial hyperplasia. Now she presented with ovarian cysts and a bilateral BSO was performed. One ovary presented a peritoneal cyst and a 3.5 cm hemangioma with hilus cell proliferation. The 3 rd case consisted in an 80-year old lady with postmenopausal bleeding and suspicion of granulosa cell tumor of the ovary. The D&C represented an endometrial polyp with simple and atypical endometrial hyperplasia and one ovary a 1.5 cm hemangioma with hilus cell hyperplasia.

Conclusions:

True hemangiomas of the ovary are rare lesions, especially those with associated hilus cell proliferation (Savargoankar et al. 1994). The differential diagnoses include reactive vascular proliferation of the ovarian hilus, steroid cell tumor with prominent vascularisation and angiosarcoma. About 5% of the cases may be associated with hormonal function and therefore associated with endometrial hyperplasia.