Chorioangioma of the Placenta

Abstract

A case of chorioangioma of the placenta is reported in which the tumor and a few of its maternal and fetal complications were detected by antenatal ultrasound examination. The clinical implications of this benign tumor for both mother and fetus are discussed.

Varying Clinical Course of Large Placental Chorioangiomas

“…Polyhydramnios, which is reported in approximately 30% of large-size chorioangiomas, and was the reason for referral in case I, is thought to develop due to the combi nation of increased transudation of fluid through the vas cular surface of the tumor and obstructed venous return [1,2,8], However, since oligohydramnios, which was found in our third case, can also occur [11], the mecha nism of fluid imbalance remains elusive. It is possible that differences in histology and vessel structure of the tumor play a different role in the etiology of fluid exchanges [7].…”

“…Although chorioangioma is a relatively frequent be nign histological finding, large size masses are often asso ciated with severe maternal and fetal complications [1][2][3][4][5], This study shows that large chorioangiomas may present without consequences to the mother and fetus, but the full-blown picture of maternal 'mirror syndrome' and fetal cardiac failure, anemia, and coagulopathy can also occur [2-5, 7, 8-10], Prenatal diagnosis of placental chorioangioma relies on the typical ultrasound appearance and is facilitated by Doppler ultrasound. Indeed, color flow and pulsed Doppler have previously been used to confirm that vascu lar channels in the tumor are continuous with the fetal circulation, ruling out other possible diagnoses such as a degenerating fibroid, placental teratoma and incomplete hydatidiform mole [4,7], Following diagnosis, the challenge for the obstetrician is to plan the best management which minimizes fetal and maternal risks.…”

“…Small-size chorioangiomas are found in 0.01-1.3% of examined placentas and are clinically irrelevant. In contrast, large masses (more than 4-5 cm in diameter) occur in 1/3,000 to 1/9,000 births [1] and may lead to polyhydramnios, maternal and fetal coag ulopathy, pre-eclampsia, preterm labor, intrauterine growth retardation, feto-maternal transfusion and fetal hydrops [2][3][4][5].…”

Chorioangioma

“…However, microscopic variability in histologic appearance [1,9]. These lesions are thought to arise from proliferation of angioblastic chorionic mesenchyme within a placental villus or, rarely, within the umbilical cord.…”

Alcohol Injection for the Intrauterine Treatment of Chorioangioma in a Pregnancy with Transfusion Resistant Fetal Anemia: A Case Report

“…In the majority of cases it is composed of capillary hemangiomas arising from chorionic plate [1] . Small microscopic chorioangiomas can be present in 1% of placentas.…”