Majeed Nasma K, Adley Brian, Guzman Grace, Mehta Vikas
Department of Pathology, University of Illinois at Chicago, Illinois, USA.
Department of Pathology, Advocate Lutheran General Hospital, Illinois, USA.
Case Rep Pathol. 2020 Feb 22;2020:5461782. doi: 10.1155/2020/5461782. eCollection 2020.
Angiosarcoma is a high-grade vascular tumor arising from endothelial cells of blood vessels. It represents less than 1% of the mesenchymal tumors. Uterine angiosarcoma is an extremely rare tumor with less than 25 cases reported in the literature. It usually presents in postmenopausal women as uterine mass and rarely can arise in a leiomyoma. It is included in the group of tumors of aggressive behavior and poor prognosis. Herein, we present a case of primary uterine angiosarcoma in a 56-year-old female patient with a history of fibroids presenting with pelvic pain and weight loss. Abdominal CT scan showed a large uterine mass and enlarged pelvic lymph nodes. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed, and on histopathologic examination, it was found to be primary epithelioid angiosarcoma of the uterus. Immunohistochemical stains for CD31, keratin MAK-6, and keratin AE1/AE3 confirmed the diagnosis. In conclusion, uterine angiosarcoma should be suspected in any rapidly growing hemorrhagic uterine mass, and appropriate sampling and immunohistochemical stains should be considered.
血管肉瘤是一种起源于血管内皮细胞的高级别血管肿瘤。它占间叶性肿瘤的比例不到1%。子宫血管肉瘤是一种极其罕见的肿瘤，文献报道不足25例。它通常在绝经后女性中表现为子宫肿块，很少可起源于平滑肌瘤。它属于具有侵袭性生物学行为和预后不良的肿瘤类别。在此，我们报告一例56岁女性原发性子宫血管肉瘤病例，该患者有肌瘤病史，表现为盆腔疼痛和体重减轻。腹部CT扫描显示子宫有一个大肿块以及盆腔淋巴结肿大。实施了全腹子宫切除术及双侧输卵管卵巢切除术，经组织病理学检查，发现为原发性子宫上皮样血管肉瘤。CD31、角蛋白MAK-6和角蛋白AE1/AE3的免疫组化染色证实了诊断。总之，对于任何快速生长的出血性子宫肿块都应怀疑子宫血管肉瘤，并应考虑进行适当的取材及免疫组化染色。
