Uterine Hemangioma Presenting as an Endometrial Polyp in a Postmenopausal Woman

Uterine hemangioma (UH) is a rare benign lesion involving the myometrium and cervix. UH often presents as an endometrial polypoid mass that mimics an endometrial polyp. UH is commonly present in women of reproductive age with menorrhagia or pregnancy-associated complications. However, reported cases in postmenopausal women present with postmenopausal bleeding. The bleeding hemangiomatous polyps are treated with hysteroscopic polypectomy. We report the case of a 65-year-old postmenopausal woman with vaginal bleeding severe enough to seek emergency medical care. Transvaginal ultrasonography showed an endometrial thickness of 10.1mm but was otherwise unremarkable. Hysteroscopic examination revealed two endometrial polyps measuring 2.0cm, and 0.5cm. Surgeons had difficulty removing these polyps using usual methods, ultimately resorting to sharp excision. Microscopic examination showed scant endometrium without hyperplasia and a polypoid lesion with numerous CD31 positive capillaries entirely filling the stroma, supporting the diagnosis of capillary hemangioma. The contributing factor to UH in our case was unclear, which opens the door for future investigation of UH in post-menopausal women.