1 Journal of Medical Case Reports 2010 Vol: 4(1):136. DOI: 10.1186/1752-1947-4-136

A rare case of abnormal uterine bleeding caused by cavernous hemangioma: a case report

Cavernous hemangiomas of the uterus are extremely rare, benign lesions. A survey of the current literature identified fewer than 50 cases of hemangioma of the uterus. Case presentation We report a case of cavernous hemangioma of the uterus in a 27-year-old Malay, para 1 woman who presented at our hospital with torrential vaginal bleeding having been transferred by land ambulance from a district hospital 30 minutes away. 11 weeks previously she had an urgent cesarean section at our hospital. She had to undergo a hysterectomy to control her bleeding after other measures were unsuccessful. A histopathological report confirmed a diffuse ramifying hemangioma of the cervix and uterus with left hematosalpinx. Most ramifying hemangioma lesions are asymptomatic and are found incidentally, but sometimes they may cause abnormal vaginal bleeding and hence should be included in the differential diagnosis of patients with vaginal bleeding. Hysterectomy is the primary mode of treatment in most symptomatic cases.

Mentions
Figures
Figure 1: Histopathology. Endothelial lined vascular spaces were seen ramifying between the uterine musculature. Figure 2: CCD34 stain. Brown endothelial cells confirming vascular spaces.
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References
  1. S Malhotra; A Sehgal; R Nijhawan Cavernous hemangioma of the uterus Int J Gynaecol Obstet 51, 159-160 (1995) .
    • . . . These lesions are associated with numerous obstetric and gynecological complications, ranging from intermenstrual spotting, menometrorrhagia and infertility to maternal and fetal demise from pronounced bleeding of the gravid uterus 1234. . . .
    • . . . All the cases of endometrial hemangiomas described in the literature to date have shown progressive symptoms of uterine bleeding which do not respond to conservative therapy 1234 . . .
  2. FK Lotgering; L Pijpers; J van Eijck; HC Wallenburg Pregnancy in a patient with diffuse cavernous hemangioma of the uterus Am J Obstet Gynecol 160, 628-630 (1989) .
    • . . . These lesions are associated with numerous obstetric and gynecological complications, ranging from intermenstrual spotting, menometrorrhagia and infertility to maternal and fetal demise from pronounced bleeding of the gravid uterus 1234. . . .
    • . . . All the cases of endometrial hemangiomas described in the literature to date have shown progressive symptoms of uterine bleeding which do not respond to conservative therapy 1234 . . .
  3. MY Dawood; ES Teoh; SS Ratnam Ruptured haemangioma of a gravid uterus J Obstet Gynaecol Br Commonw 79, 474-475 (1972) .
    • . . . These lesions are associated with numerous obstetric and gynecological complications, ranging from intermenstrual spotting, menometrorrhagia and infertility to maternal and fetal demise from pronounced bleeding of the gravid uterus 1234. . . .
    • . . . All the cases of endometrial hemangiomas described in the literature to date have shown progressive symptoms of uterine bleeding which do not respond to conservative therapy 1234 . . .
  4. C Johnson; M Reid-Nicholson; L Deligdisch; S Grinblat; S Natarajan Capillary hemangioma of the endometrium: a case report and review of the literature Arch Pathol Lab Med 129, 1326-1329 (2005) .
    • . . . These lesions are associated with numerous obstetric and gynecological complications, ranging from intermenstrual spotting, menometrorrhagia and infertility to maternal and fetal demise from pronounced bleeding of the gravid uterus 1234. . . .
    • . . . All the cases of endometrial hemangiomas described in the literature to date have shown progressive symptoms of uterine bleeding which do not respond to conservative therapy 1234 . . .
  5. MW Sütterlin; T Müller; M Rehn; A Rempen; J Dietl Successful abdominal delivery in a woman with sonographic diagnosis of diffuse cavernous hemangioma of the uterus Am J Perinatol 15, 423-425 (1998) .
    • . . . In a few cases the uterus has been reported to be pulsatile 5 . . .
  6. DT Hunter; FW Coggins Endometrial hemangiomata; report of a case Obstet Gynecol 25, 538-541 (1965) .
    • . . . Non-surgical modalities such as radiotherapy would probably cure the lesions but in the process would destroy ovarian function 6. . . .