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Case Reports
. 2020 Sep 18;99(38):e22325.
doi: 10.1097/MD.0000000000022325.

A retroperitoneal cavernous hemangioma arising from the gonadal vein: A case report

Chun-Yo Laih  1 , Po-Fan Hsieh  1   2   3 , Guang-Heng Chen  1 , Han Chang  3   4 , Wei-Ching Lin  2   5 , Chun-Ming Lai  6 , Chao-Hsiang Chang  1
Affiliations
Case Reports

A retroperitoneal cavernous hemangioma arising from the gonadal vein: A case report

Chun-Yo Laih et al. Medicine (Baltimore). .

Abstract

Rationale: Cavernous hemangioma (CH) is not commonly found within the abdomen or the retroperitoneum. We report the first case of CH originating from the gonadal vein.

Diagnosis: A retroperitoneal tumor was found incidentally in a 57-year-old female patient. The differential diagnoses from the initial imaging studies included gastrointestinal stromal tumor, carcinoid tumor, neurogenic tumor, metastasis, lymphadenopathy, or another rare tumor.

Interventions: A surgical en-bloc excision was performed via a subcostal incision and intravenous CH arising from a gonadal vein was diagnosis by the urological pathologist.

Outcomes: After the surgery, no complications were noted. A computed tomography scan was performed after 3 months follow-up and no tumor recurrence was found.

Lessons: This case reminds us that CH should be listed as one of the differential diagnoses for a retroperitoneal tumor. A definite diagnosis of CH relies on surgical resection. The prognosis is well if adequate resection is performed.

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Figures

Figure 1
Figure 1
A heterogeneous hypoechoic lesion measuring 4.5 × 3.9 cm was found over the right retroperitoneal cavity by ultrasound, and induced right moderate hydronephrosis.
Figure 2
Figure 2
CT scan showed heterogeneous enhancement over the right retroperitoneum. (A) Transverse view, (B) coronal view. CT = computed tomography.
Figure 3
Figure 3
(A) and (B): Gross examination of the resected specimen.
Figure 4
Figure 4
(A) The cavernous hemangioma arising from the venous wall, and protruding into the venous lumen and extending into the adventitia. V, vein; T, tumor; scale bar, 1 mm. (B) High magnification shows the tumor composed of variable-sized benign capillaries and small venules. Scale bar, 100 mm. (C) CD31 immunoreactivity to the vascular endothelia of the veins and capillaries in the tumor. V, vein; T, tumor; scale bar, 200 μm. (D) Actin immunoreactivity to the vascular walls of the veins and capillaries in the tumor. V, vein; T, tumor; scale bar, 200 μm. (E) Elastic-van-gieson staining shows the black elastic fibers in the venous wall, confirming the cavernous hemangioma arising from the venous wall. V, vein; T, tumor; scale bar, 200 μm.
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References

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