A giant early second‐trimester placental chorioangioma associated with isolated proteinuria and histopathologically confirmed placental insufficiency, a novel association: A case report

Abstract

We present a case of giant chorioangioma at 18 weeks of gestation leading to fetal hypertrophic cardiomyopathy without other evidences of fetal volume overload and late‐onset isolated proteinuria. Oligohydramnios developed at term and placental insufficiency was confirmed on histopathological examination and a nonanemic nonthrombocytopenic normal weight healthy baby was delivered.

Multiple Giant Placental Chorioangioma: A Case Report

“…Placental Chorioangioma is a non-trophoblastic tumor originating from primitive chorionic mesenchyme 10 . While the definitive cause of the condition remains elusive, various risk factors have been associated with its onset, including primiparity, maternal age exceeding 30, multiple pregnancies, maternal hypertension and diabetes, as well as carrying a female fetus 11,12 . Our case aligned with these findings as it involved multiple pregnancies, high blood pressure, preeclampsia, and a female fetus.…”

“…Small-sized chorioangiomas are often incidentally discovered during the third trimester, whereas larger tumors (>4cm) are more easily identified 13 . The diagnosis primarily relies on ultrasound, where they appear as well-defined lesions with distinct echogenicity compared to surrounding tissue 11,14,15 . They are commonly found in close proximity to the cord insertion site on the fetal surface of the placenta, where they extend into the amniotic cavity 16 .…”

“…These shunts compromise the perfusion of chorionic villi, leading to reduced delivery of essential nutrients and oxygen to the fetal circulation. As a result, the fetal heart compensates to maintain tissue perfusion 1,7,11 . However, inadequate compensation may result in cardiac failure and hydrops fetalis, which often leads to adverse outcomes and fetal mortality 3 , as observed in our case.…”