Burnett School of Medicine, Texas Christian University, Fort Worth, TX, USA.
Department of Obstetrics and Gynecology, Dokuz Eylül University, Izmir, Turkey.
Reprod Sci. 2024 Nov;31(11):3351-3356. doi: 10.1007/s43032-024-01675-9. Epub 2024 Aug 19.
Cavernous hemangioma within the female genital tract is an extremely rare pathology, characterized by irregular vascular spaces containing blood or thrombus. We present a unique case of a 42-year-old primiparous woman who presented with typical endometriosis symptoms such as dysmenorrhea, dyspareunia, and heavy menstrual bleeding. The patient also experienced complex postpartum symptoms, which were misdiagnosed as cholecystitis and retained placental products. Imaging studies suggested deep infiltrative endometriosis with extraovarian endometriotic lesions. Surgical exploration revealed a hemangioma within the right anterior broad ligament alongside peritoneal endometriosis lesions. The hemangioma itself expresses estrogen and progesterone receptors in stromal cells. The presence of steroid hormone receptors strongly suggests symptom alleviation during the menstrual cycle and the postpartum period. The coexistence of cavernous hemangioma and endometriosis in the broad ligament, previously unreported, and symptomatic overlap between the two conditions complicates diagnosis and management, emphasizing the need for comprehensive evaluation integrating clinical symptoms and imaging findings.
女性生殖道海绵状血管瘤是一种极为罕见的病变,特征为含有血液或血栓的不规则血管腔。我们报告了一例 42 岁初产妇的独特病例,该患者表现出典型的子宫内膜异位症症状,如痛经、性交痛和月经过多。该患者还出现了复杂的产后症状,被误诊为胆囊炎和胎盘残留。影像学研究提示深部浸润性子宫内膜异位症伴卵巢外子宫内膜异位病灶。手术探查发现右侧前阔韧带内有血管瘤,同时伴有腹膜子宫内膜异位症病灶。血管瘤本身在基质细胞中表达雌激素和孕激素受体。甾体激素受体的存在强烈提示在月经周期和产后期间症状缓解。阔韧带中同时存在海绵状血管瘤和子宫内膜异位症,此前尚未报道,且两者的症状重叠,这使得诊断和管理变得复杂,强调需要综合评估临床症状和影像学发现。