[OVARIAN ANASTOMOSING HEMANGIOMA WITH STROMAL LUTEINIZATION: A CASE REPORT]

In 2009, Montgomery and Epstein coined the term "anastomosing hemangioma" for a newly described variant of capillary hemangioma with an unusual sinusoidal pattern, histologically mimicking angiosarcoma. The lesion was considered unique for genitourinary system with predilection to kidney but we found in the literature only 4 cases of this entity in ovaries. A 70-year-old woman presented with ultrasound visualized myometrial nodules and cystic formation of the right ovary, intraoperatively diagnosed as serous cystadenoma. Hysterectomy with bilateral adnexectomy was performed. The section of the ovary revealed a fortuitous finding in the cortex: circumscribed lesion, 7 mm in diameter, with mahogany brown, spongy appearance. Microscopic examination of H&E-stained slides manifested well-demarcated but un-encapsulated vascular proliferation, composed of tightly packed capillary-sized blood vessels with an anastomosing sinusoidal-like architecture and tortuous "feeding" and "draining" vessels of medium caliber. Endothelial lining featured only mild cytologic atypia and lack of mitotic figures. The lesion was surrounded by luteinized ovarian stroma. Immunohistochemical examination with CD34 highlighted endothelial cells; SMA--supporting stromal cells. The anastomosing hemangioma of the ovary with stromal luteinisation was diagnosed as accidental finding. The authors discuss morphological characteristics of anastomosing hemangioma and the unusual for menopausal women but quite often combination between this lesion in the ovary and stromal luteinisation.