Low-Grade Uterine Epithelioid Hemangioendothelioma Presented as a Submucosal Leiomyoma during Labor

Abstract

With the exception of leiomyomas, soft tissue tumors of the uterine corpus are not common. This is particularly true for vascular neoplasms, with the epithelioid hemangioendothelioma being a curiosity; not more than twenty-two cases of malignant hemangioendotheliomas have been reported in the literature so far, all of which were high-grade hemangioendotheliomas (hemangiosarcomas). We present herewith a unique case of low-grade epithelioid hemangioendothelioma of the uterus in a pregnant woman aged 29 years. The clinical, histological, and immunohistochemical characteristics of this entity, together with its differential diagnosis, are discussed.

Figure 1

(a) and (b) tissue sections showing well-formed vascular channels embedded in a myxoid stroma. Note focal areas of abortive endothelial differentiation (hematoxylin and eosin stained sections, (a) magnification ×200 and (b) magnification ×400). Insert in (b) displays the presence of an intracytoplasmic vacuole containing a single erythrocyte (arrowhead) (magnification ×600). (c) and (d) neoplastic cells demonstrating strong diffuse immunoreactivity for the endothelial markers CD31 (c) and CD34 (d), magnification ×200.