P14.53: Characteristics of umbilical cord with single artery in healthy and malformed fetuses

Abstract

Congenital teratomas of the umbilical cord are extremely rare. Only eleven case are known in the literature and two of those were associated with exomphalos. A 23-year old mother was performed a routine ultrasound examination in the 17 week of gestation. The ultrasonographic examination revealed a 49 × 25 mm midline sac adjacent to the anterior abdominal wall containing a solid and cystic mass. The parents asked for termination of pregnancy. The fetus weighed 131 g without the tumor. From 4 mm of the fetal end the cord contained a sac, measuring 5.5 × 6 × 6 cm, covered by transparent membranes. Fetal organs, small and large bowels with appendix, and the spleen were herniated into the exomphalos, as well as a solid and cystic tumor mass of 3 × 3.5 × 4 cm. Examination of the did not revealed any further malformation, histology of parenchymal organs showed normal development. The placenta was of normal size and shape but an unusual membranous sac was attached to the fetal surface, marginally. It was connected with the umbilical cord with an amniotic band. Microscopical examination of the tumor revealed complex structure consisting of various tissues from the three germinal layers. Mature tissue types were represented by well differentiated respiratory and intestinal glands, skin with dermal appendages, islets of cartilage, renal glomeruli, smooth muscle fibers, and ganglion cells, scattered in mesenchymal tissue. Large amount of immature neural tissue was present. Malignant component was not detected. The tumor was diagnosed as a benign immature umbilical cord teratoma. In the course of ultrasonographic scanning umbilical cord teratoma might be suspected when a solid and cystic, rapidly growing lesion is seen, attached to the cord in midline location. When the tumor is surrounded by membranous structures and hiding in an omphalocele the narrowing of the cord between the tumor and the abdominal wall could be a useful sign. P14.52Haemangioma of the umbilical cord diagnosed prenatally Hospital Geral Santo António, PortugalTumors of the umbilical cord are uncommon findings that can be discovered prenatally by ultrasound scanning. The authors report a case of a 31-year-old woman, presented for her first sonogram at 14 weeks' gestation a mass between the fetus and placenta. At 22 weeks of gestation the tumor was thought to be an haemangioma of the umbilical cord, measuring 57 × 52 mm. The fetus did not presented any morphological defects. Subsequent evaluation at 32 weeks of gestation revealed persistence of the tumor mass of the umbilical cord, measuring 70 × 60 mm. A caesarean section was performed at 37 weeks' gestation. The umbilical cord measured 340 mm in length and consisted of a short normal part extending to the navel, a ovoid swellings with 70 mm in diameter and a spiral part extending to the placenta. The cut surface of the mass revealed a pseudocyst formation, a gelatine-like swelling and three umbilical vessels. Histologically, the tumor have the appearances of capillary haemangioma. There are only 31 cases ...