Anastomosing Hemangioma of Ovary with Stromal Luteinization Masquerading as Sex Cord-Stromal Tumor on Intraoperative Consultation.

Anastomosing hemangiomas (AHs) are benign vascular tumor with rare occurrence in the ovary and the majority being asymptomatic. We report one such case of AH with stromal luteinization. A 35-year-old female had complaints of abdominal pain and heavy menstrual bleeding for 2 years. Her lactate dehydrogenase was markedly raised. Following the clinical suspicion of germ cell tumor, exploratory laparotomy and right salpingo-oophorectomy were done. On frozen section due to extensive stromal luteinization, diagnosis of sex cord-stromal tumor was suggested. However, the case was finally diagnosed with AH with extensive stromal luteinization. This case highlighted the potential mimics of AH due to coexistent raised biomarkers and secondary changes, thereby posing a diagnostic dilemma on intraoperative consultation.

Cystic Anastomosing Hemangioma of the Ovary: A Case Report With Immunohistochemical and Ultrastructural Analysis.

In this article, we present a case of anastomosing hemangioma that shows cystic change. The tumor was a unilocular cystic lesion consisting of 2 distinct layers. The inner layer was composed of a proliferation of capillary-sized blood vessels resembling red pulp of the spleen. The outer layer was composed of stromal cells that resembled Leydig or steroid cell tumor of the ovary. An immunohistochemical examination confirmed endothelial and stromal characteristics of the layers, respectively. An ultrastructural analysis revealed absence of Reinke crystalloids in the stromal cells. We conclude that anastomosing hemangioma may rarely arise from the ovary as a cystic tumor and may be accompanied with luteinization of stromal cells.

Anastomosing Hemangioma of the Ovary: A Clinicopathological Study of Six Cases with Stromal Luteinization.

We report six cases of anastomosing hemangioma of the ovary. All lesions were unilateral and arose in 43 to 81 year old females. In all but one patient, the tumor was asymptomatic and represented incidental finding. The exception was a tumor associated with massive ascites and elevated CA 125. The tumors were, on cut section, spongy and dark violet in color. The size of tumors ranged from 0.5 to 3.5 cm. All lesions showed the same histological features and consisted of capillary sized anastomosing vessels with sinusoid-like pattern intermingled with sporadic medium sized vessels. Interestingly, in all cases there were areas of luteinized cells at the tumor periphery, which ranged from rare small nests to multiple and commonly confluent areas. In one tumor, components of mature adipose tissue were present. Immunohistochemically, all tumors were CD31 and CD34 positive. Other markers examined were negative, including; estrogen receptor, progesterone receptor, androgen receptor, and D2-40. Proliferative activity (Ki-67 index) was very low in all cases. Anastomosing hemangioma is a rare entity, only 8 lesions occurring in ovary has been described from its initial description in 2009. We report six additional cases with their clinicopathological correlation.

Linear and micronodular neuroendocrine cell hyperplasia in an ovarian mucinous cystadenoma.

We report a rare case of an ovarian mucinous cystadenoma in which there were peculiar neuroendocrine micronests composed of gastrin-immunoreactive cells. There was no clinical evidence of hypergastrinemia. The mucinous component of the neoplasm was represented by columnar cells mostly expressing a gastric phenotype with MUC5AC and claudin 18 positivity, which was consistent with the presence of interspersed gastrin cells. The tumoral stroma displayed areas of luteinization with cells intensely positive for α-inhibin, MART-1 and calretinin.