Uterine angiomatosis as an unexpected cause of refractory pelvic pain and heavy menstrual bleeding: a case report and literature review

Angiomatosis is a rare benign vascular lesion characterised by diffuse, haphazard proliferation of blood vessels, most commonly within adipose and fibrous tissue. This report describes the case of a patient in her early 30s who presented with refractory menorrhagia and pelvic pain. Following total laparoscopic hysterectomy with bilateral salpingectomy, histopathological examination identified angiomatosis of the uterine corpus and cervix. This finding is exceptionally rare, with only five cases reported in the literature. Conventional investigations, including ultrasonography and hysteroscopy, may be inadequate, with definitive diagnosis often established only on postoperative histopathological analysis. Medical management appears largely ineffective in symptom control, with most reported cases resulting in hysterectomy. Given the limited number of reported cases, the natural progression of this condition is largely unknown, and postoperative surveillance may be warranted.