Uterusun diffüz kavernöz hemanjiyomunun antenatal sonografik tanısı

Year 2014, Volume: 27 Issue: 2, 134 - 137, 20.05.2014

Aytül Çorbacıoğlu Esmer Mehmet Özsürmeli Atıl Yüksel İbrahim Kalelioğlu Recep Has Nevin Bakar

Abstract

Uterusun kavernöz hemanjiyomu, endometriyal polip veya myoma
benzeyen bir kitle şeklinde ortaya çıkabileceği gibi (lokalize tip),
uterus duvarında normal myometriumun yerini alan geniş vaskuler
boşluklar şeklinde de (diffüz tip) görülebilir. Genellikle
asemptomatiktir, ancak jinekolojik pratikte menometroraji ve
infertilite şeklinde, obstetrik hastalarda ise intrapartum veya
postpartum kanama ya da tromboembolizm şeklinde ortaya çıkabilir.
Diffüz kavernöz hemanjiyom, türbülan akım içeren kavernöz
boşluklarla dolu kalınlaşmış uterus duvarı görüntüsüyle, rutin
antenatal ultrasonografi incelemesi sırasında nadiren saptanabilir.
Fetusta ağır gelişme geriliği olan, sezaryen sırasında ve sonrasında
hemorajik komplikasyon gelişmeyen ve antenatal dönemde tanısı
koyulan bir diffüz kavernöz hemanjiyom olgusu sunmaktayız.

Keywords

Kavernöz hemanjiyom, Uterus, Antenatal tanı, Ultrasonografi

Antenatal sonographic diagnosis of diffuse cavernous hemangioma of the uterus

Abstract

Cavernous hemangioma of the uterus may be either localized
presenting as an endometrial polyp or a uterine mass mimicking
myoma, or as a diffuse mass in which most of the uterine wall is
composed of enlarged vascular spaces replacing the normal
myometrium. It is usually asymptomatic, but can present with
menometrorrhagia and infertility in gynecological practice, and
intra or postpartum bleeding or thromboembolism in obstetric
patients. Diffuse cavernous hemangioma can be seldom, identified
during routine antenatal ultrasonographic examination as the
thickened uterine wall composed of cavernous fluid-filled spaces
with turbulent flow. We present an antenatally diagnosed case of
diffuse cavernous hemangioma in which the fetus was severely
growth-restricted. Caesarean section was performed successfully
without any intra or postpartum hemorrhage. 

Keywords

Cavernous hemangioma, Uterus, Antenatal diagnosis, Ultrasonography

References

• 1. Bhavsar T, Wurzel J, Duker N. Myometrial cavernous hemangioma with pumonary thromboembolism in a post-partum woman: a case report and review of the literature. J Med Case Rep 2012;6:397. doi: 10.1186/1752-1947-6-397.
• 2. Sharma JB, Chanana C, Gupta SD, et al. Cavernous hemangiomatous polyp: an unusual case of perimenopausal bleeding. Arch Gynecol Obstet 2006;274:206-8. doi:10.1007/s00404-006-0161-z.
• 3. Lee EJ, Kim SH, Kim YH. Uterine cavernous haemangioma in a post-menopausal woman: CT and MRI findings mimicking uterine myoma with degeneration. Br J Radiol 2011;84:e68-71. doi: 10.1259/bjr/56484373.
• 4. Benjamin MA, Yaakub HR, Telesinghe PU, et al. A rare case of abnormal uterine bleeding caused by cavernous hemangioma: a case report. J Med Case Rep 2010;4:136. doi: 10.1186/1752-1947-4-136.
• 5. Verheijen RH, van Rijen-de-Rooij HJ, van Zundert AA, et al. Pregnancy in a patient with Klippel-Trenaunay-Weber syndrome: a case report. Eur J Obstet Gynecol Reprod Biol 1989;33:89-94. doi: 10.1016/0028-2243(89)90083-X.
• 6. Comstock CH, Monticello ML, Johnson TW, et al. Cavernous hemangioma: diffuse enlarged venous spaces within the myometrium in pregnancy. Obstet Gynecol 2005;106:1212-14. doi:10.1097. AOG.000016404.99506.C8.
• 7. Paltiel HJ, Burrows PE, Kozakewich HP, Zurakowski D, Mulliken JB. Soft-tissue vascular anomalies: Utility of US for diagnosis. Radiology 2000;214:747-54.
• 8. Hyodoh H, Hori M, Akiba H, et al. Peripheral vascular malformations: Imaging, treatment approaches, and therapeutic issues. RadioGraphics 2005;25:S159-71. doi: 10.1148/rg.25si055509
• 9. Elsayes KM, Menias CO, Dillman JR, Platt JE, Willatt JM, Heiken JP. Vascular malformations and hemangiomatosis syndromes: Spectrum of imaging manifestations. AJR 2008;190:1291-9. doi: 10.2214/AJR.07.2779.
• 10. Virk RK, Zhong J, Lu D. Diffuse cavernous hemangioma of the uteus in a pregnant woman: report of rare case and review of literature. Arch Gynecol Obstet 2009;279:603-5. doi: 10.1007/s00404-008- 0764-7.
• 11. Sütterlin MW, Müller T, Rehn M, Rempen A, Dietl J. Successful abdominal delivery in a woman with sonographic diagnosis of diffuse cavernous hemangioma of the uterus. Am J Perinatol 1998;15:423- 25. doi:10.1055/s-2007-993969.
• 12. Lotgering FK, Pijpers L, van Eijck J, Wallenburg HCS. Pregnancy in a patient with diffuse cavernous hemangioma of the uterus. Am J Obstet Gynecol 1989;160:628-30. doi:10.1016/S0002- 9378(89)80044-4.
• 13. Weissman A, Talmon R, Jakobi P. Cavernous hemangioma of the uterus in a pregnant woman. Obstet Gynecol 1993;81:825-7.
• 14. Thanner F, Suetterlin M, Kenn W, et al. Pregnancy-associated diffuse cavernous hemangioma of the uterus. Acta Obstet Gynecol Scand 2001;80:1150-1. doi: 10.1034/j.1600-0412.2001.801217.x
• 15. Hadlock FP, Deter RL, Carpenter R, Park SK, Athey PA.Hypervascularity of the uterine wall during pregnancy: incidence, sonographic appearence, and obstetric implications. J Clin Ultrasound 1980;8:399-403. doi:10.1002/jcu.1870080502.
• 16. Acevado Gallegos S, Gallardo Gaona JM, Velazquez Torres B, Espino I Sosa S, Santarrosa Pérez MA, Guzmán Huerta ME. Diffuse cavernous hemangioma of the uterus diagnosed during pregnancy. Case report. Ginecol Obstet Mex 2011;79:447-51.
• 17. Richard DS, Cruz AC. Sonographic demonstration of wide-spread uterine angiomatosis in a pregnant patient with Klippel-TrenaunayWeber Syndrome. J Ultrasound Med 1997;16:631-33.
• 18. Bree AF, Siegfried E, Sotelo-Avila C, et al. Infantile hemangiomas: speculation on placental trophoblastic origin. Arch Dermatol 2001;137:573-7.