A Collision between Cavernous-Capillary Hemangioma with Stromal Luteinization and Serous Cystadenoma

Abstract

A collision tumor represents a coexistence of two adjacent but histologically distinct tumors without histologic admixture in an organ. Serous tumors of the ovary are the most common forms of epithelial tumors, and cavernous hemangiomas are rare in the ovary. However, a collision between them is an extremely rare pathology. Here the author presents a report of a 74-year-old woman whose ultrasound examines establishes rounded left ovary formation with hypo- and hyperdense sections. Paraclinical: CA125 within normal range. Serum levels free testosterone 3.79 nmol/l (normal 0.49-2.64 nmol/l for women). The histology showed benign serous cystadenoma and vascular lesions composed of capillary and cavernous vessels amongst luteinized stromal cells. The luteinized cells were positive for inhibin A. The endothelial cells were negative for estrogen and progesterone receptor. A search was conducted in the Medline database via PubMed using the terms: ‘hemangioma’, ‘ovary’, ‘collision’, ‘serous cystadenoma’, no more than 70 articles for ovarian hemangiomas appeared, and no articles for a collision between serous cystadenoma and mixed hemangioma with stromal luteinization in the ovary. From the reference, this is the first reported case of collision between serous cystadenoma and mixed cavernous-capillary hemangioma with stromal luteinization in the ovary. This rare case of collision between tumors in the ovary sheds light on possible tumor pathology in the woman’s reproductive system, which must be considered by gynaecologists and pathologists.