Department of Pathology, Tai'an Central Hospital, No. 29, Longtan Road, Tai'an, 271000, China.
J Ovarian Res. 2021 Jan 28;14(1):21. doi: 10.1186/s13048-021-00771-7.
The diagnosis of primary angiosarcoma of ovary is still a challenge as it has no specific clinical symptoms and is easily confused with other malignant neoplasms in morphology. Here, we described a case of primary ovarian angiosarcoma and reviewed the literature. A 47-year-old female showed a left ovary mass. Grossly, the cut surface of the tumor was solid and gray-white with intermediate texture. Some areas were spongy and atropurpureus with a soft texture. Microscopically, the tumor cells were arranged into a variety of different structures with visible hemorrhage. Immunochemically, the tumor cells were positive for CD31, ERG, Fli1, D2-40 and vimentin in a strong and diffused manner. CD34 stain showed focal positivity. Epithelial markers (e.g. CK, CK7, CK8/18 and PAX8) were all negative. Negative immunostaining for SMA, S-100, P53 and calretinin also were detected. The proliferative index (Ki-67) was approximately 40%. After surgery, the patient was treated with radiotherapy, targeted therapy and immunotherapy. In the 9-month follow-up, the patient was survival without evidence of disease. The diagnosis of ovarian angiosarcoma required the careful observation of morphology and the reasonable application of immunohistochemistry. Targeted therapy and immunotherapy are the potential directions for the treatment of angiosarcoma.
原发性卵巢血管肉瘤的诊断仍然具有挑战性，因为它没有特定的临床症状，并且在形态学上容易与其他恶性肿瘤混淆。在此，我们描述了一例原发性卵巢血管肉瘤，并复习了文献。一名 47 岁女性表现为左卵巢肿块。大体上，肿瘤切面实性，灰白，质地中等。部分区域呈海绵状，暗紫色，质地柔软。镜下，肿瘤细胞排列成多种不同结构，可见出血。免疫组化染色显示，肿瘤细胞强弥漫性表达 CD31、ERG、Fli1、D2-40 和波形蛋白。CD34 染色呈局灶性阳性。上皮标志物（如 CK、CK7、CK8/18 和 PAX8）均为阴性。平滑肌肌动蛋白、S-100、P53 和钙视网膜蛋白的免疫组化染色均为阴性。增殖指数（Ki-67）约为 40%。手术后，患者接受了放疗、靶向治疗和免疫治疗。在 9 个月的随访中，患者无病生存。卵巢血管肉瘤的诊断需要仔细观察形态学，并合理应用免疫组织化学。靶向治疗和免疫治疗是血管肉瘤治疗的潜在方向。
