{"paper_id":"6f17f893-ea4c-44dd-98af-7945117b881c","body_text":"Abstract\nCavernous hemangioma within the female genital tract is an extremely rare pathology, characterized by irregular vascular spaces containing blood or thrombus. We present a unique case of a 42-year-old primiparous woman who presented with typical endometriosis symptoms such as dysmenorrhea, dyspareunia, and heavy menstrual bleeding. The patient also experienced complex postpartum symptoms, which were misdiagnosed as cholecystitis and retained placental products. Imaging studies suggested deep infiltrative endometriosis with extraovarian endometriotic lesions. Surgical exploration revealed a hemangioma within the right anterior broad ligament alongside peritoneal endometriosis lesions. The hemangioma itself expresses estrogen and progesterone receptors in stromal cells. The presence of steroid hormone receptors strongly suggests symptom alleviation during the menstrual cycle and the postpartum period. The coexistence of cavernous hemangioma and endometriosis in the broad ligament, previously unreported, and symptomatic overlap between the two conditions complicates diagnosis and management, emphasizing the need for comprehensive evaluation integrating clinical symptoms and imaging findings.\nSimilar content being viewed by others\nData Availability\nIf needed, we can provide further information.\nCode Availability\nNot applicable.\nReferences\nAka KE, et al. A rare case of important and recurrent abnormal uterine bleeding in a post partum woman caused by cavernous hemangioma: a case report and review of literature. Pan Afr Med J. 2017;28. https://doi.org/10.11604/pamj.2017.28.130.10084.\nRamos H, Thummala N, Jacques SM, Gogoi R. A rare case of ovarian hemangioma in a 30-year-old nulligravid woman. Radiol Case Rep. 2023;18(2):613–9. https://doi.org/10.1016/j.radcr.2022.10.100.\nKalaivanan C, Subbarayan D, Kanna N, Nayar S. Capillary hemangioma: A concurrent presentation in ovary and fallopian tube. J Midlife Health. 2019;10(2):93–95. https://doi.org/10.4103/jmh.JMH_51_18\nKatiyar R, Patne SCU, Bharti S, Jain M. Capillary hemangioma of the fallopian tube. J Clin Diagn Res. 2016;10(4):QD01–2. https://doi.org/10.7860/JCDR/2016/16774.7570.\nFarahani M, Hashemi SA, Goodarzi S, Hajikarimloo B, Pour-Ghazi F, Noori S, Alijani S, Khavandegar A. A rare case report of cervical hemangioma and a comprehensive literature review of 137 cases of cervical and uterine hemangiomas. Int J Gynaecol Obstet. 2024;164(2):421–35. https://doi.org/10.1002/ijgo.14961.\nBennis A, et al. Epidural cavernous haemangioma during pregnancy: a case report and a literature review. Pan Afr Med J. 2019;33. https://doi.org/10.11604/pamj.2019.33.202.8481.\nBulun SE. Endometriosis caused by retrograde menstruation: now demonstrated by DNA evidence. Fertil Steril. 2022;118(3):535–6. https://doi.org/10.1016/j.fertnstert.2022.07.012.\nBulun SE, et al. Endometriosis and adenomyosis: shared pathophysiology. Fertil Steril. 2023;119(5):746–50. https://doi.org/10.1016/j.fertnstert.2023.03.006.\nSeckin T, Yuksel B, Seckin S, Ayhan A, Ayhan YA. ABC of endometriosis surgery: Aqua Blue contrast technique. medRxiv. 2020. https://doi.org/10.1101/2020.02.27.20027888\nJohnson C, Reid-Nicholson M, Deligdisch L, Grinblat S, Natarajan S. Capillary hemangioma of the endometrium: a case report and review of the literature. Arch Pathol Lab Med. 2005;129(10):1326–9. https://doi.org/10.5858/2005-129-1326-CHOTEA.\nYang GZ, Li J, Jin H. Giant mesenteric hemangioma of cavernous and venous mixed type: a rare case report. BMC Surg. 2013;13(1). https://doi.org/10.1186/1471-2482-13-50.\nReggiani Bonetti L et al. Sep., Expression of estrogen receptor in hemangioma of the uterine cervix: Reports of three cases and review of the literature, Arch Gynecol Obstet. 2009;280(3):469–472. https://doi.org/10.1007/s00404-009-0928-0\nBusca A, Parra-Herran C. Hemangiomas of the uterine cervix: Association with abnormal bleeding and pain in young women and hormone receptor expression. Report of four cases and review of the literature. Pathol Res Pract. Jun. 2016;212(6):532–8. https://doi.org/10.1016/j.prp.2016.03.003.\nChodankar RR, Murray A, Nicol M, Whitaker LHR, Williams ARW, Critchley HOD. The endometrial response to modulation of ligand-progesterone receptor pathways is reversible, Fertil Steril. 2021;116(3):882–895. https://doi.org/10.1016/j.fertnstert.2021.02.008\nBulun SE, Yang S, Fang Z, Gurates B, Tamura M, Sebastian S. Estrogen Production and metabolism in endometriosis. Ann NY Acad Sci. 2002;955(1):75–85. https://doi.org/10.1111/j.1749-6632.2002.tb02767.x.\nNisolle M, Donnez J. Peritoneal endometriosis, ovarian endometriosis, and adenomyotic nodules of the rectovaginal septum are three different entities. Fertil Steril. 1997;68(4):585–596. https://doi.org/10.1016/s0015-0282(97)00191-x\nHorne A, Daniels J, Hummelshoj L, Cox E, Cooper K. Surgical removal of superficial peritoneal endometriosis for managing women with chronic pelvic pain: time for a rethink? BJOG. 2019;126(12):1414–1416. https://doi.org/10.1111/1471-0528.15894\nTrehan A, Trehan AK. Endometrioma contained within the broad ligament. Case Reports. 2014;2014: bcr2013203441. https://doi.org/10.1136/bcr-2013-203441\nFendal Tunca A, Iliman DE, Akdogan Gemici A, Kaya C. Predictive value of preoperative MRI using the #ENZIAN classification score in patients with deep infiltrating endometriosis. Arch Gynecol Obstet. 2023;307(1):215–20. https://doi.org/10.1007/s00404-022-06451-1.\nAcknowledgements\nThere is no acknowledgment in this study.\nFunding\nThis research received no specific grant from funding agencies in the public, commercial, or not-for-profit sectors.\nAuthor information\nAuthors and Affiliations\nContributions\nTimur Seckin prepared, drafted, and revised the manuscript. Hakan Kula assisted with data collection, writing, manuscript preparation, and submission. Amanda Chu and Sabina Hajiyeva aided in data collection. Amanda Chu and Tamer Seckin conducted the critical review. All authors approved the submitted version and agreed to be personally accountable for their contributions, ensuring that any questions regarding the accuracy or integrity of the work are appropriately investigated and documented in the literature.\nCorresponding author\nEthics declarations\nEthics Approval\nNot applicable.\nConsent to Participate\nInformed consent is taken from the patient for participation and publication.\nConsent for Publication\nInformed consent is taken from the patient for participation and publication.\nCompeting Interests\nThe authors declare that they have no competing interests. Timur Seckin, Hakan Kula, Amanda Chu, and Sabina Hajiyeva declare they have nothing to disclose. Tamer Seckin declares that he has a leadership role with the Endometriosis Foundation of America.\nAttestation Statement\nData regarding any of the subjects in the study has not been previously published unless specified. Data will be made available to the journal editors for review or query upon request.\nAdditional information\nPublisher’s Note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nRights and permissions\nSpringer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.\nAbout this article\nCite this article\nSeckin, T., Kula, H., Chu, A. et al. Rare Broad Ligament Cavernous Hemangioma Mimicking Advanced Endometriosis: A Case Report. Reprod. Sci. 31, 3351–3356 (2024). https://doi.org/10.1007/s43032-024-01675-9\nReceived:\nAccepted:\nPublished:\nVersion of record:\nIssue date:\nDOI: https://doi.org/10.1007/s43032-024-01675-9","source_license":"CC0","license_restricted":false}