Skip to main content

Advertisement

Log in

Primary angiosarcoma of the ovary complicated by hemoperitoneum: a case report and review of the literature

  • Case Report
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Background

Sarcomas of the female genital tract are very rare. A small subset of these, primary ovarian angiosarcoma, is even more rare, with only 26 cases reported in the literature. Most cases of advanced-stage disease are aggressive and demonstrate a poor response to both surgery and chemotherapy with an overall poor prognosis.

Case

We present a case of a previously healthy 67-year-old woman who presented with abdominal pain and profound anemia. She underwent a full staging and optimal debulking that revealed Stage IIIC primary ovarian angiosarcoma. The patient died 3 weeks post-operatively secondary to hemorrhage from progressive, metastatic tumor sites prior to initiation of chemotherapy.

Conclusion

Primary ovarian angiosarcoma is extremely rare, often presenting in later stages with nonspecific symptoms. Immunohistochemical staining of pathological specimens can aid in the diagnosis. The optimal regimen for adjuvant chemotherapy is unknown, and the prognosis is very poor.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

References

  1. Furihata M, Takeuichi T, Iwata J, Sonobe H, Ohtsuki Y, Wakatsuki A et al (1998) Primary ovarian angiosarcoma: a case report and literature review. Pathol Int 48(12):967–973. doi:10.1111/j.1440-1827.1998.tb03868.x

    Article  CAS  PubMed  Google Scholar 

  2. Chen KT, Hoffman KD, Hendricks EJ (1979) Angiosarcoma following therapeutic irradiation. Cancer 44(6):2044–2048. doi:10.1002/1097-0142(197912)44:6<2044::AID-CNCR2820440614>3.0.CO;2-U

    Article  CAS  PubMed  Google Scholar 

  3. Dannaher CL, Tamburro CH, Yam LT (1981) Chemotherapy of vinyl chloride-associated hepatic angiosarcoma. Cancer 47:466–469. doi:10.1002/1097-0142(19810201)47:3<466::AID-CNCR2820470307>3.0.CO;2-F

    Article  CAS  PubMed  Google Scholar 

  4. Jha S, Chan KK, Poole CJ, Rollason TP (2005) Pregnancy following recurrent angiosarcoma of the ovary: a case report and review of literature. Gynecol Oncol 97(3):935–937. doi:10.1016/j.ygyno.2005.02.027

    Article  PubMed  Google Scholar 

  5. Quesenberry CD, Li C, Chen AH, Zweizig SL, Ball HG 3rd (2005) Primary angiosarcoma of the ovary: a case report of stage I disease. Gynecol Oncol 99(1):218–221. doi:10.1016/j.ygyno.2005.05.044

    Article  PubMed  Google Scholar 

  6. Nucci MR, Krausz T, Lifshitcs-Mercer B et al (1998) Angiosarcoma of the ovary: clinicopathologic and immunohistochemical analysis of four cases with a broad morphologic spectrum. Am J Surg Pathol 22:620–630. doi:10.1097/00000478-199805000-00014

    Article  CAS  PubMed  Google Scholar 

  7. Cunningham MJ, Brooks JSJ, Noumoff JS (1994) Treatment of primary ovarian angiosarcoma with ifosfamide and doxorubicin. Gynecol Oncol 53:265–268. doi:10.1006/gyno.1994.1128

    Article  CAS  PubMed  Google Scholar 

  8. den Bakker MA, Ansink AC, Ewing-Graham PC (2006) “Cutaneous-type” angiosarcoma arising in a mature cystic teratoma of the ovary. J Clin Pathol 59(6):658–660. doi:10.1136/jcp.2005.029751

    Article  Google Scholar 

  9. Jylling AM, Jorgensen L, Holund B (1999) Mucinous cystadenocarcinoma in combination with hemangioasarcoma in the ovary. Pathol Oncol Res 5:318–319. doi:10.1053/paor.1999.0213

    Article  CAS  PubMed  Google Scholar 

  10. Lifshitz-Mercer B, Ledier-Trejo L, Messer G, Peyser MR, Czernobilsky B (1998) Primary angiosarcoma of the ovary: a clinicopathologic, immunohistochemical and electronmicroscopic study. Pathol Res Pract 194(3):183–187

    Google Scholar 

  11. Nara M, Sasaki T, Shimura S, Yamamoto M, Oshiro T, Kaiwa Y et al (1996) Diffuse alveolar hemorrhage caused by lung metastasis of ovarian angiosarcoma. Intern Med 35(8):653–656. doi:10.2169/internalmedicine.35.653

    Article  CAS  PubMed  Google Scholar 

  12. Nielson GP, Young RH, Prat J et al (1997) Primary angiosarcoma of the ovary: a report of seven cases and review of the literature. Int J Gynecol Pathol 16:378–382

    Article  Google Scholar 

  13. Ongkasuwan C, Taylor JE, Tang CK, Prempree T (1982) Angiosarcomas of the uterus and ovary: clinicopathologic report. Cancer 49(7):1469–1475. doi:10.1002/1097-0142(19820401)49:7<1469::AID-CNCR2820490726>3.0.CO;2-K

    Article  CAS  PubMed  Google Scholar 

  14. Patel T, Ohri SK, Sundaresan M, Jackson J, Desa LA, Davey AT et al (1991) Metastatic angiosarcoma of the ovary. Eur J Surg Oncol 17:295–299

    CAS  PubMed  Google Scholar 

  15. Pillay K, Essa AS, Chetty R (2001) Borderline serous cystadenocarcinoma with coexistent angiosarcoma: and unusual form of ovarian carcinosarcoma. Int J Surg Pathol 9:317–321. doi:10.1177/106689690100900411

    Article  CAS  PubMed  Google Scholar 

  16. Platt JS, Rogers SJ, Flynn EA et al (1999) Primary angiosarcoma of the ovary: a case report and review of the literature. Gynecol Oncol 73:443–446. doi:10.1006/gyno.1998.5335

    Article  CAS  PubMed  Google Scholar 

  17. Twu NF, Juang CM, Yeng MS, Lu CJ, Lai CZ, Chao KC (1999) Treatment of primary pure angiosarcoma of ovary with multiple lung metastases: a case report. Eur J Gynaecol Oncol 20(5–6):383–385

    CAS  PubMed  Google Scholar 

  18. Davidson B, Abeler VM (2005) Primary ovarian angiosarcoma presenting as malignant cells in ascites: case report and review of the literature. Diagn Cytopathol 32(5):307–309. doi:10.1002/dc.20245

    Article  PubMed  Google Scholar 

  19. Vavilis D, Papadopoulos N, Agorastos T, Efstratious I, Kommoss F, Botnis IN (2007) Primary ovarian angiosarcoma—review of the literature and report of a case with coexisting chylothorax. Eur J Gynaecol Oncol 28(4):287–289

    CAS  PubMed  Google Scholar 

  20. Dirix LY, VanOosterom AT (1989) Role of ifosfamide in the treatment of sarcomas. Semin Oncol 16:39

    CAS  PubMed  Google Scholar 

  21. Antman KH, Crowley J, Balcerzak SP et al (1993) An intergroup phase III randomized study of doxorubicin and dacarbazine with or without ifosfamide and mesna in advanced soft tissue and bone sarcomas. J Clin Oncol 11(7):1276–1285

    CAS  PubMed  Google Scholar 

  22. Fata F, O’Reilly E, Ilson D et al (1999) Paclitaxel in the treatment of patients with angiosarcoma of the scalp or face. Cancer 86:2034–2037. doi:10.1002/(SICI)1097-0142(19991115)86:10<2034::AID-CNCR21>3.0.CO;2-P

    Article  CAS  PubMed  Google Scholar 

  23. Azoury RS, Woodruff JD (1971) Primary ovarian sarcomas. Report of 43 cases from the Emil Novak Ovarian Tumor Registry. Obstet Gynecol 37:920–941

    CAS  PubMed  Google Scholar 

  24. Oshawa M, Naka N, Tomita Y, Kawamori D, Kanno H, Aozasa K (1995) Use of immunohistochemical procedures in diagnosing angiosarcoma. Cancer 75(12):2867–2873. doi:10.1002/1097-0142(19950615)75:12<2867::AID-CNCR2820751212>3.0.CO;2-8

    Article  Google Scholar 

  25. Meis-Kindblom JM, Kindblom LG (1998) Angiosarcoma of soft tissue. A study of 80 cases. Am J Surg Pathol 22:683–697. doi:10.1097/00000478-199806000-00005

    Article  CAS  PubMed  Google Scholar 

Download references

Conflict of interest statement

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Leslie Bradford.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bradford, L., Swartz, K. & Rose, S. Primary angiosarcoma of the ovary complicated by hemoperitoneum: a case report and review of the literature. Arch Gynecol Obstet 281, 145–150 (2010). https://doi.org/10.1007/s00404-009-1092-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-009-1092-2

Keywords

Navigation