Abstract:

Primary ovarian epithelioid angiosarcoma is a rare and aggressive ovarian malignant tumor originating from endothelial cells. Its clinical symptoms are non-specific, making early diagnosis difficult. It progresses rapidly, has a high recurrence rate, is insensitive to traditional chemotherapy and radiotherapy, and has a poor prognosis. Surgical resection is the most definite treatment method. This paper reports a case of primary ovarian epithelioid angiosarcoma. The patient presented with abnormal uterine bleeding and lower abdominal pain for 3 months, which worsened in the last 2 days. Imaging examinations suggested a hypoechoic mass in the right adnexal area, and ovarian cancer was suspected. Pre-operative diagnosis considered the possibility of a rupture of an ovarian malignant tumor. Thus, a laparotomy was performed. During the operation, a cystic-solid mixed mass with a diameter of about 10 cm was found in the right adnexal area. The surface of the mass had abundant, thick blood vessels, the capsule was ruptured, and there was a small amount of active bleeding. Then, cytoreductive surgery for ovarian tumor was carried out. According to the pathological diagnosis, it was stage ⅢB primary ovarian epithelioid angiosarcoma. After 1 course of intravenous chemotherapy with 100 mg of cisplatin and 80 mg of doxorubicin, the patient did not receive treatment as scheduled for 50 days. When she was readmitted to the hospital, recurrence had occurred in multiple lesions in the lungs, pelvis, and abdominal cavity. The disease progressed rapidly, and the patient eventually died 3 months after the surgery.

Key words: Ovarian neoplasms, Hemangiosarcoma, Diagnosis, Therapy, Prognosis