Ovarian angioleiomyoma: a case report

Abstract

Angioleiomyoma (ALM) is a rare and painful, benign neoplasm that is referred to an uncommon type of leiomyoma originating from smooth muscle cells of arterial and venous walls. ALM is very rarely found in the female genital organs such as uterus or ovary. Herein, we present the case of a huge primary ovarian ALM in a 35 year-old woman, clinically and radiologically mimicking an ovarian fibroma, which histologically has diffuse myxoid degeneration. This is the third case of ovarian ALM and the first case of ovarian ALM with diffuse degeneration reported in English literatures, to the best of our knowledge.

Keywords: Angioleiomyoma; degeneration; ovary.

Figure 1

Ultrasonographic findings of the tumor. A huge solid mass without cystic contents is shown in pelvic cavity, which is attached to the right adnexa and uterine serosa (A). The observed left adnexa are unremarkable (B).

Figure 2

Microscopic features of the tumor with hematoxylin-eosin staining. The tumor consists of intersecting fascicles of spindle cells with eosinophilic cytoplasm and regular bland blunt nuclei, merged into numerous vascular structures with thick and proliferated walls and several dilated lumina. Diffuse myxoid and hyaline degeneration is observed in the background of fascicles, which has multinodular appearance. (A: ×100, B: ×200).

Figure 3

Immunohistochemical characteristics of the tumor. The spindle cells express diffused α-smooth muscle actin (α-SMA) (A). Progesterone receptors are focally positive in these spindle cells (B). CD 31 is expressed in the endothelial cells, but it is negative in spindle cells (C). (×200).