Moreno-López JC, Gutiérrez-Sánchez EF, Herrera-Barrera LE, Murillo-Bargas H

Language: Spanish
References: 10
Page: 635-640
PDF size: 211.25 Kb.

ABSTRACT

Background: Placental chorioangioma is the most common placental tumor: it is found in 1% of pregnancies. This tumor causes: growth restriction, anemia, thrombocytopenia and polyhydramnios, especially in cases with chorioangioma larger than 5 cm in diameter (giant chorioangioma). Almost all are small and can be found in pathologic examinations and without complications.
Clinical case: A 40-year-old multigestation patient in the second trimester of pregnancy. Obstetric ultrasound showed an isoechoic image in the distal third, towards the posterior aspect, with peripheral and central vascularity on power Doppler, measuring 68.4 x 63.6 mm, data compatible with a giant placental chorioangioma. Mascroscopic pathology report: monochorionic monoamniotic placenta of 505 g, placental disc 16 x 16 x 3.5 cm; the umbilical cord: 8 x 12 cm, central insertion, 3 vascular lights inside. Placental chorioangioma 5 cm in greatest diameter with areas of calcifications. Histological sections reported: tertiary chorionic villi with heterogeneous maturation, small and short, with increased syncytial nodules in 50% of the placental thickness and extensive infarcts.
Conclusions: To strengthen prenatal diagnosis it is necessary to understand the influence of placental chorioangioma on the fetus and the mother; to know the selected cases that will require fetal therapy in case of complications. Careful follow-up through ultrasound surveillance of the placenta and fetus is decisive.

REFERENCES

1. Lim Foong, Coleman A, Polzin, Jaekle W, et al. Giant Chorioangiomas: Perinatal Outcomes and Techniques in Fetoscopic Devascularization. Fetal Diagnosis and Therapy 2015; 37 (1): 18-23. https://doi.org/10.1159/000363600

2. Sepúlveda W, Wong AE, Herrera L, Dezerega L, Devoto JC. Endoscopic laser coagulation of feeding vessels in large placental chorioangiomas: report of three cases and review of invasive treatment options. Prenatal Diagnosis 2009; 29 (3): 201-6. https://doi.org/10.1002/pd.2197

3. Buca D, Iacovella C, Khalil A, Rizzo G, et al. Perinatal outcome of pregnancies complicated by placental chorioangioma: a systematic review and meta‐analysis. J Ultrasound Med 2019; 55(1): 441-49. doi:10.1002/uog.20304.

4. Iacovella C, Chandrasekaran N, Khalil A, Bhide A, et al. Fetal and placental vascular tumors: persistent fetal hyperdynamic status predisposes to poorer long-term neurodevelopmental outcome. J Ultrasound Med 2014; 43 (6): 658-61. https://doi.org/10.1002/uog.13272

5. Liu Haiyan, Gu Weirong, Li Xiaotian. Natural history and pregnancy outcome in patients with placental chorioangioma. Journal of Clinical Ultrasound 2014; 42(2): 74-80. https://doi.org/10.1002/jcu.22101

6. Zanardini C, Papageorghiou A, Bhide A, Thilaganathan B. Giant placental chorioangioma: natural history and pregnancy outcome. Ultrasound in Obstetrics & Gynecology 2010; 35 (3): 332-36. https://doi.org/10.1002/ uog.7451

7. 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 (9): 671-74. https://doi.org/10.1016/j.placenta. 2011.06.007

8. Gajewska K, Herinckx A, Holoye A, D'Haene N, et al. Antenatal embolization of a large chorioangioma by percutaneous Glubran 2 injection. J Ultrasound Med 2010; 36 (6): 773-75. https://doi.org/10.1002/uog.8806

9. Muñoz López M, Comas Gabriel C, Torres Mund M, Muñoz Prades A, et al. Diagnóstico prenatal de corioangioma placentario y gestación a término. Prog en Obstet y Ginecol 2013; 56 (2): 94-100. https://doi.org/10.1016/j. pog.2012.05.009

10. Jones K, Tierney K, Grubbs BH, Pruetz JD, et al. Fetoscopic laser photocoagulation of feeding vessels to a large placental chorioangioma following fetal deterioration after amnioreduction. Fetal Diagn and Ther 2012; 31 (3): 191-95. https://doi.org/10.1159/000331944