Giant chorioangioma of placenta: an infrequent placental cause for adverse feto-maternal outcome
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20150122Keywords:
Giant placental chorioangioma, Feto-maternal outcomeAbstract
Chorioangioma is a relatively rare benign tumor of placenta arising from chorionic tissue, with incidence being 1 in 100 cases. Giant vascular chorioangiomas render a challenge to obstetricians with their potential critical complications adversely altering feto-maternal outcome. Diagnosis is suspected antenatally by ultrasound and Doppler studies, and is corroborated by histopathology post-delivery. Here we report a pregnancy complicated by a giant placental chorioangioma with polyhydraminos in a young mother, diagnosed prenatally, and associated with deranged liver function tests, culminating into a preterm delivery of a plethoric stillborn fetus, followed by life-threatening postpartum hemorrhage in mother. Also clinical considerations and relevant literature review on prognostic factors affecting obstetric outcome are addressed. A case of giant chorioangioma placenta warrants close antenatal surveillance and institutional delivery as it may have untoward maternal complications as was seen. Vascularization of tumor is a pivotal determining factor of pregnancy outcome.References
Burcu Artunc Ulkumen, Halil Gursoy Pala, Nalan Nese, Yesim Baytur. Prenatal diagnosis and fetomaternal outcomes of two cases with placental chorioangioma. Case Rep Obstet Gynecol. 2013;2013:926743.
Bassel H. Al Wattar, Sarah C. Hillman, Tamas Marton, Katharine Foster, Mark D. Kilby. Placenta chorioangioma: a rare case and systematic review of literature. J Matern Fetal Neonatal Med. 2014;27(10):1055-63.
Sepulveda W, Alcalde JL, Schnapp C, Bravo M. Perinatal outcome after prenatal diagnosis of placental chorioangioma. Obstet Gynecol. 2003;102:1028-33.
Lutgardo García-Díaz, Práxedes Carreto, Susana Costa-Pereira, Guillermo Antinolo. Prenatal management and perinatal outcome in giant placental chorioangioma complicated with hydrops fetalis, fetal anemia and maternal mirror Syndrome. BMC Pregnancy Childbirth. 2012;12:72.
Guschmann M, Henrich W, Dudenhausen JW. Chorioangiomas - new insights into a well-known problem. II. An immunohistochemical investigation of 136 cases. J Perinat Med. 2003;31:170-5.
Ogino S, Redline RW. Villous Capillary lesions of the placenta: distinctions between chorioangioma, chorioangiomatosis and chorioangiosis. Hum Pathol. 2000;31:945-54.
Wou K, Chen MF, Mallozzi A, Brown RN, Shrim A. Pregnancy outcomes and ultrasonographic diagnosis in patients with histologically-proven placental chorioangioma. Placenta. 2011;32:671-4.
Sreelakshmi Kodandapani, Abha Shreshta, Vani Ramkumar, Lakshmi Rao. Chorioangioma of placenta: a rare placental cause for adverse fetal outcome. Case Rep Obstet Gynecol. 2012;2012:913878.
Kirkpatrick AD, Podberesky DJ, Gray AE, McDermott JH. Placental chorioangioma. Radiographics. 2007;27(4):1187-90.
Barros A, Freitas AC, Cabral AJ, Camacho MC, Costa E, Leitão H, et al. Giant placental chorioangioma: a rare cause of fetal hydrops. BMJ Case Rep. 2011;2011:pii: bcr0220113880.
Wehrens XH, Offermans JP, Snijders M, Peeters LL. Fetal cardiovascular response to large placental chorioangiomas. J Perinat Med. 2004;32:107-12.
Zalel Y, Weisz B, Gamzu R, Schiff E, Shalmon B, Achiron R. Chorioangiomas of the placenta: sonographic and Doppler flowcharacteristics. J Ultrasound Med. 2002;21(8):909-13.
Zanardini C, Papageorghiou A, Bhide A, Thilaganathan B. Giant placental chorioangioma: natural history and pregnancy outcome. Ultrasound Obstet Gynecol. 2010;35:332-6.
Maymon R, Hermann G, Reish O, Herman A, Strauss S, Sherman D, et al. Chorioangioma and its severe infantile sequelae: case report. Prenat Diagn. 2003;23:976-80.
Jauniaux E, Ogle R. Color Doppler imaging in the diagnosis and management of chorioangiomas. Ultrasound Obstet Gynecol. 2000;15:463-7.
Abramowicz JS, Sheiner E. In utero imaging of the placenta: importance for diseases of pregnancy. Placenta. 2007;28:S14-22.
Blaicher W, Brugger PC, Mittermayer C, Schwindt J, Deutinger J, Bernaschek G, et al. Magnetic resonance imaging of the normal placenta. Eur J Radiol. 2006;57:256-60.
Sepulveda W, Wong AE, Herrera L, Dezerega V, Devoto JC. Endoscopic laser coagulation of feeding vessels in large placental chorioangiomas: report of three cases and review of invasive treatment options. Prenat Diagn. 2009;29:201-6.
Bhide A, Prefumo F, Sairam S, Carvalho J, Thilaganathan B. Ultrasound-guided interstitial laser therapy for the treatment of placental chorioangioma. Obstet Gynecol. 2003;102:1189-91.
Nicolini U, Zuliani G, Caravelli E, Fogliani R, Poblete A, Roberts A. Alcohol injection: a new method of treating placental chorioangiomas. Lancet. 1999;353:1674-5.
Amer HZ, Heller DS. Chorangioma and related vascular lesions of the placenta - a review. Fetal Pediatr Pathol. 2010;29:199-206.
Kriplani A, Abbi M, Banerjee N, Roy KK, Takkar D. Indomethacin therapy in the treatment of polyhydramnios due to placental chorioangioma. J Obstet Gynaecol Res. 2001;27:245-8.
Sivaslı E, Tekşam Ö, Haliloğlu M, Güçer S, Orhan D, Gürgey A, et al. Hydrops fetalis associated with chorioangioma and thrombosis of umbilical vein. Turk J Pediatr. 2009;51:515-8.
Quintero RA, Reich H, Romero R, Johnson MP, Gonçalves L, Evans MI. In utero endoscopic devascularization of a large chorioangioma. Ultrasound Obstet Gynecol. 1996;8:48-52.
