Cavernous hemangioma: diffuse enlarged venous spaces within the myometrium in pregnancy

Diffuse enlarged vessels throughout the myometrium are very rare. This case illustrates the diagnosis and clinical management of a pregnancy complicated by large vessels diffusely distributed throughout the myometrium.

A primigravida measured large for dates at 27 weeks gestation. Ultrasonography demonstrated tubular echolucent spaces throughout the myometrium. No flow could be detected within them by color or spectral Doppler. During cesarean delivery blood loss was 1,700 mL, but the uterus was successfully closed with 3 suture layers. A biopsy specimen showed myometrium containing large vascular spaces thought to be veins, consistent with a hemangioma.

Enlarged vascular spaces diffusely distributed throughout the myometrium proved to be a cavernous hemangioma. Cesarean delivery in the present case produced some additional bleeding that was easily controlled, and the uterus was closed without incident.