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MRI and CT demonstrated endometrial and bilateral ovarian masses with multiple cavitating lung nodules, consistent with metastatic disease, stage four B according to the International Federation of Gynaecology and Obstetrics classification (FIGO stage IVB). During oral progesterone therapy for abnormal uterine bleeding, lung metastases initially regressed before subsequently progressing. The patient underwent total abdominal hysterectomy, bilateral removal of fallopian tubes and ovaries and omental biopsy. Histopathology confirmed high-grade epithelioid angiosarcoma with bilateral serous borderline ovarian tumours. Despite surgical management, she experienced rapid disease progression and died 5\u2009months after surgery.<\/jats:p>","DOI":"10.1136\/bcr-2025-269159","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T14:30:18Z","timestamp":1777041018000},"page":"e269159","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Uterine angiosarcoma diagnosed solely by endometrial biopsy and the effect of oral progesterone treatment on associated lung metastases"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-7357-4742","authenticated-orcid":false,"given":"Rafeef","family":"Abu Shamleh","sequence":"first","affiliation":[{"name":"Gynaecology Oncology, Swansea Bay University Health Board, Swansea, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nagindra","family":"Das","sequence":"additional","affiliation":[{"name":"Gynae Oncology, Swansea Bay 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