Abstract
INTRODUCTION AND IMPORTANCE: Uterine vascular tumors are rare neoplastic lesions that grow independently and may sometimes regress. They include hemangiomas, lymphangiomas, arteriovenous malformations, and angiosarcomas. Often they are asymptomatic and incidental, some can mimic gynecologic tumors. These lesions may affect the uterine serosa, myometrium, or endometrium. Lymphangiomas, especially in the uterine corpus are extremely rare and typically benign formed by dilated lymphatic channels infiltrating surrounding tissue. CASE PRESENTATION: A 55-year-old postmenopausal woman presented with lower abdominal pain, increased urinary frequency, and a palpable abdominal mass. Imaging suggested a sub-serosal fibroid, and she underwent total abdominal hysterectomy + bilateral salpingo-oophorectomy (TAH + BSO). Histopathology revealed dilated vascular channels lined by flattened endothelium with positive D2-40 immunostaining which confirmed a diagnosis of uterine cavernous lymphangioma. The patient remained symptom-free with no recurrence at 6-month follow-up. DISCUSSION: Uterine lymphangiomas are extremely rare, especially in postmenopausal women. They often mimic fibroids on imaging, particularly when cystic changes are present, making diagnosis difficult. Definitive diagnosis relies on histopathology, which distinguishes lymphangiomas by their dilated lymphatic vessels. Complete surgical excision is the preferred treatment to prevent recurrence, and long-term follow-up is essential due to the potential for delayed recurrence. CONCLUSION: Uterine cavernous lymphangiomas are rare benign tumors that can resemble common gynecologic masses. Diagnosis relies on histopathology, and complete surgical removal is key to preventing recurrence. Due to their rarity, individualized care and specialist input are crucial.