case_images: PMC11788454_01
case_images: Removed right ovarian tumor. The tumor was located anterior to the right ureter, medial to the right internal iliac artery, in continuity with the pelvic infundibular ligament, and was judged to be a right ovary. The tumor was found to be partially ruptured and hemorrhaging.
case_images: cureus-0017-00000076849-i01.jpg
case_images: PMC11788454_01_cureus-0017-00000076849-i01.jpg
case_images: FIG1
case_images: Although the left adnexa was not visible, the right ovary was found to be partially ruptured and hemorrhaging (Figure 1).
case_images: Pathological findings. The tumor is observed to have developed contiguously from the ovarian parenchyma. The vascular endothelium is displaced and occupied by the tumor cells. Each tumor cell includes well-defined, round nucleoli, an eosinophilic endoplasmic reticulum, and a highly atypical nucleus. Angiosarcoma was diagnosed based on the presence of vascular endothelial markers CD31, ERG, and CD34. (A) Hematoxylin-eosin stain, (B) CD31, (C) ERG, and (D) CD34. This pathology image is at 200x magnification.
case_images: cureus-0017-00000076849-i02.jpg
case_images: PMC11788454_01_cureus-0017-00000076849-i02.jpg
case_images: FIG2
case_images: The basis for the diagnosis is "multilayering of endothelial cells, nuclear atypia, increased mitoses, necrosis" and "positive for vascular markers, such as CD31, CD34, ERG, VEGF and factor VIII, by immunohistochemistry" (Figures 2A-2D).
case_images: Clinical progress. This figure shows trends in serum hemoglobin levels in relation to the blood transfusions received.
case_images: cureus-0017-00000076849-i03.jpg
case_images: PMC11788454_01_cureus-0017-00000076849-i03.jpg
case_images: FIG3
case_images: The patient died 44 days after admission without achieving hemostasis (Figure 3).
case_images: Autopsy findings. (A) Right salpingo-oophorectomy site. (B) Entire intraperitoneal region.. The peritoneal seeding nodules are centered on the right salpingo-oophorectomy site and extended into the intraperitoneal region.. (C, D) Left lung metastasis. A dark brown nodule, 2 cm in diameter, is seen (red arrows). No evidence of mediastinal metastases is seen, indicating hematogenous metastasis.
case_images: cureus-0017-00000076849-i04.jpg
case_images: PMC11788454_01_cureus-0017-00000076849-i04.jpg
case_images: FIG4
case_images: Since there were no disseminated nodules in the thoracic cavity or on the thoracic surface of the diaphragm and some pathological findings for vascular invasion, the diagnosis of hematogenous metastasis was made (Figures 4A-4D).