title: Ovarian hemangioma presenting with hyperandrogenism and endometrial cancer: a case report.
abstract: BACKGROUND
  Hemangiomas are very rare tumors of the ovary. Here, we report a case of a mixed capillary and cavernous ovarian hemangioma and endometrial carcinoma presenting with postmenopausal bleeding, male pattern receding frontal hairline, and high serum androgen and estradiol levels.
  
  
  METHODS
  A 70-year-old White female underwent laparotomy for endometrial carcinoma. Intraoperative frozen-section examination of the uterus revealed a 3.5 x 3 cm, grade 1 endometrioid adenocarcinoma of the endometrium with more than 50% myometrial invasion. The left ovary contained a 1.5 x 1 x 1 cm, well-circumscribed hemorrhagic nodule on the cut surface. Final histopathological examination of the small nodule demonstrated multiple, enlarged, blood-filled vascular channels lined by a single layer of flattened regular endothelial cells with no atypical features. Vascular spaces within the tumor were of different sizes, ranging from small to large, and were separated by connective tissue. The surrounding ovarian stroma was hyperplastic and contained clusters of luteinized stromal cells. Microscopy of the right ovary showed minimal stromal proliferation and no luteinization of the ovarian stroma.
  
  
  CONCLUSIONS
  This is the first case of an ovarian hemangioma synchronous with a well-differentiated endometrial carcinoma. Absence of estrogen and progesterone receptors in the endothelial cells of the hemangioma suggests that ovarian hemangiomas may occur independent of stimulation by estrogen and progesterone.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Trakya University, Edirne, Turkey. fgucer@yahoo.com
authors.forename: Fatih
authors.initials: F
authors.lastname: Gücer
authors.forename: Filiz
authors.initials: F
authors.lastname: Ozyilmaz
authors.forename: Petek
authors.initials: P
authors.lastname: Balkanli-Kaplan
authors.forename: Naciye
authors.initials: N
authors.lastname: Mülayim
authors.forename: Ozgür
authors.initials: O
authors.lastname: Aydin
mesh_terms: D000368:Aged; D000728:Androgens / Q000097:blood; D018269:Carcinoma, Endometrioid / Q000097:blood / Q000150:complications* / Q000473:pathology; D016889:Endometrial Neoplasms / Q000097:blood / Q000150:complications* / Q000473:pathology; D004958:Estradiol / Q000097:blood; D005260:Female; D006392:Hemangioma, Cavernous / Q000097:blood / Q000150:complications* / Q000473:pathology; D006801:Humans; D017588:Hyperandrogenism / Q000097:blood / Q000150:complications* / Q000473:pathology; D009378:Neoplasms, Multiple Primary / Q000097:blood / Q000473:pathology; D010051:Ovarian Neoplasms / Q000097:blood / Q000150:complications* / Q000473:pathology; D017698:Postmenopause; D014592:Uterine Hemorrhage / Q000209:etiology
chemical_list: D000728:Androgens; D004958:Estradiol