Chorioangioma in pregnancy: a case report

Rio Yoga Erlambang; I Wayan Artana Putra

doi:10.15562/ism.v12i1.857

Chorioangioma in pregnancy: a case report

Rio Yoga Erlambang ,

I Wayan Artana Putra ,

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DOI: https://doi.org/10.15562/ism.v12i1.857 |
Published: 2021-04-01

Abstract

Background: Placental chorioangioma is a rare benign non-trophoblastic tumor of the placenta, derived from primitive chorionic mesenchyme. It can cause adverse outcomes on the mother and fetus, depending on its size. Most of the cases are accidentally detected during ultrasonography because small size tumors are usually asymptomatic. However, larger size of tumor can cause complications such as fetal anemia, fetal hydrops, polyhydramnios, premature birth, intrauterine growth restriction, and fetal death.

Case report: A 27-year-old primigravida presented at Sanglah Hospital gynecology polyclinic at 27^th-28^th week of gestation. She was referred by an obstetric and gynecologist due to polyhydramnion since 26^th-27^th week of gestation. A 7.86 x 8.19 cm hypoechoic cysts with hyperechoic border were found during fetal scanning. Chorioangioma was suspected with SDP 9.11 cm. Amniocentesis was planned, however the patient had a premature uterine contraction. By this time, the fundal height was accordant with 31^st-32^nd week of gestation, and speculum examination showed rupture of membrane with 4 cm cervix dilation. Spontaneous vaginal delivery was performed and a boy neonate with 4/6 Apgar score and birth weight of 1150 g was delivered. Placenta was extracted out completely. There was no complication after delivery process. Macroscopic and microscopic placental examination confirmed the initial diagnosis, chorioangioma.

Conclusion: Early management in determining the cause of polyhydroamnion is challenging and needs comprehensive investigation. Ultrasonography is a choice of method in initial detection of polyhydroamnion. Serial ultrasonography is needed to evaluate the amount of amniotic fluid and detect the probable cause of complications for mother, fetus, and delivery process. One of the complications is premature uterine contraction that causes premature birth. As a result, the fetus may not be viable and this remains one of the biggest challenges for clinicians. There are several possible causes that cannot be ruled out from polyhydroamnion differential diagnoses, such as a rare placental tumor chorioangioma.

References

Williams Obstetrics. Implantation, Embryogenesis, and Placental Development: Introduction. 24th ed. 2014. pp. 116-125.
Arulkumaran S, Sivanesaratnam V, Chatterjee A, Kumar P. Essentials of Obstetrics. 3rd ed. Jaypee Brothers Medical Publishers (P) Ltd. 2004. pp. 82-85.
Liu CC, Pretorius DH, Scioscia AL, Hull AD. Sonographic prenatal diagnosis of marginal placental cord insertion: Clinical importance. Journal of Ultrasound in Medicine. 2002;21:627-632.
Rhone SA, Magee F, Remple V. The association of placental abnormalities with maternal and neonatal clinical findings: A retrospective cohort study. Journal of Obstetrics and Gynaecology Canada. 2003;25(2):123-128.
DC Dutta’s Textbook of Obstetrics. The Placenta and Fetal Membranes. 7th ed. 2018. pp. 28-37.
Guschmann M, Henrich W, Dudenhausen JW. Chorioangiomas-new insights into a well-known problem. II. An immunohistochemical investigation of 136 cases. Journal of Perinatal Medicine. 2003;31:170-175.
Fan M, Skupski DW. Placental chorioangioma: a literature review. Journal of Perinatal Medicine. 2014;42(3):273-279.
Ropacka-Lesiak M, Gruca-Stryjak K, Breborowicz G. Nontrophoblastic placental tumors. Neuro Endocrinol Lett. 2012;33:375-9.
Kodandapani S, Shreshta A, Ramkumar V, Rao L. Chorioangioma of Placenta: A Rare Placental Cause for Adverse Fetal Outcome. Case Reports in Obstetrics and Gynecology. 2012:913878.
Marchetti AA. A consideration of certain types of benign tumors of the placenta. Surgery, Gynecology & Obstetrics. 1939;68:733-743.

[1] Williams Obstetrics. Implantation, Embryogenesis, and Placental Development: Introduction. 24th ed. 2014. pp. 116-125.

[2] Arulkumaran S, Sivanesaratnam V, Chatterjee A, Kumar P. Essentials of Obstetrics. 3rd ed. Jaypee Brothers Medical Publishers (P) Ltd. 2004. pp. 82-85.

[3] Liu CC, Pretorius DH, Scioscia AL, Hull AD. Sonographic prenatal diagnosis of marginal placental cord insertion: Clinical importance. Journal of Ultrasound in Medicine. 2002;21:627-632.

[4] Rhone SA, Magee F, Remple V. The association of placental abnormalities with maternal and neonatal clinical findings: A retrospective cohort study. Journal of Obstetrics and Gynaecology Canada. 2003;25(2):123-128.

[5] DC Dutta’s Textbook of Obstetrics. The Placenta and Fetal Membranes. 7th ed. 2018. pp. 28-37.

[6] Guschmann M, Henrich W, Dudenhausen JW. Chorioangiomas-new insights into a well-known problem. II. An immunohistochemical investigation of 136 cases. Journal of Perinatal Medicine. 2003;31:170-175.

[7] Fan M, Skupski DW. Placental chorioangioma: a literature review. Journal of Perinatal Medicine. 2014;42(3):273-279.

[8] Ropacka-Lesiak M, Gruca-Stryjak K, Breborowicz G. Nontrophoblastic placental tumors. Neuro Endocrinol Lett. 2012;33:375-9.

[9] Kodandapani S, Shreshta A, Ramkumar V, Rao L. Chorioangioma of Placenta: A Rare Placental Cause for Adverse Fetal Outcome. Case Reports in Obstetrics and Gynecology. 2012:913878.

[10] Marchetti AA. A consideration of certain types of benign tumors of the placenta. Surgery, Gynecology & Obstetrics. 1939;68:733-743.

Chorioangioma in pregnancy: a case report

Abstract

References

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