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Placental chorioangioma: case report

Year 2014, Volume: 45 Issue: 4, 165 - 170, 19.08.2014

Abstract

Chorioangiomas are the most common benign tumors of placenta. In our case, a 30 years old woman, gravida 2, para 1 at 22 weeks of gestation was referred to our Perinathology Department due to high levels of maternal serum alfa-feto protein (MSAFP). Doppler ultrasonography showed that the placenta was attached to left-posterior wall of uterus and a 40x38 mm solid, vascularized mass was present in it. No fetal abnormality was detected. Patient was followed with preliminary diagnose of placental chorioangioma and at 32 weeks of gestation, it was detected that the size of the mass was 64x54 mm and accompanied by polyhydroamnios. Patient was hospitalized because of abnormal umbilical artery doppler finding as absence of end diastolic flow. After applying corticosteroids and completion of fetal lung maturation , a caesarean section was performed due to previous ceaserean delivery history. Diagnose of placental choriangioma was confirmed after pathological examination. As a result, we suggest; detailed evaulation of placenta should be performed in patients with elevated MSAFP levels. Patients with preliminary diagnose of placental chorioangioma should be followed closely for possible fetal and maternal complications.

Key words: Maternal Serum Alfa-Fetoprotein,  Chorioangioma, Doppler  Ultrasonography

References

  • (1) Benirschke K, Kaufmann P, Baergen RN. Benign tumors and chorangiosis. In Pathology of Human Placenta (5th ed), Benirschke K, Kaufmann P (eds). Springer: New York, 2006. pp 863–76.
  • (2) Sepulveda W, Alcalde JL, Schnapp C, Bravo M. Perinatal outcome after prenatal diagnosis of placental chorioangioma. Obstet Gynecol 2003;102:1028–33.
  • (3) Fox H, Sebire NJ. Non-trophoblastic tumors of the placenta. In Pathology of the Placenta (3rd edn), Fox H, Sebire N (eds). Saunders Elsevier: Philadelphia, 2007. pp 401–30.
  • (4) Quarello E, Bernard JP, Leroy B, Ville Y. Prenatal laser treatment of a placental chorioangioma. Ultrasound Obstet Gynecol. 2005;25:299–301.
  • (5) Zanardini C, Papageorghiou A, Bhide A, Thilaganathan B. Giant placental chorioangioma: natural history and pregnancy outcome. Ultrasound Obstet Gynecol 2010;35:332–6.
  • (6) Knoth M, Rygaard J, Hesseldahl H. Chorioangioma with hydramnios and intrauterine fetal death. Acta Obstetricia at Gynaecologica Scandinavica 1990;55:279-281.
  • (7) Froehlich LA, Fujikura T, Fisher P. Chorioangiomas and their clinical implications. Obstet Gynecol 1971;37:51–59.
  • (8) Moncusa A, D’Anna R, Corrado F, Cannata M. Large placental choriangioma. Acta Obstet Gynecol Scand 2001;80:965-966.
  • (9) Bromley B, Benacerraf BR. Solid masses on the fetal surface of the placenta: differential diagnosis and clinical outcome. J Ultrasound Med 1994;13:883–886.
  • (10) Zalel Y, Weisz B, Gamzu R, Schiff E, Shalmon B, Achiron R. Chorioangiomas of the placenta: sonographic and Doppler flow characteristics. J Ultrasound Med. 2002;21:909-13.
  • (11) Wallenburg HCS. Chorioangioma of the placenta. Thirteen new cases and a review of the literature from 1939 to 1970 with special reference to the clinical complications. Obstet Gynecol Surv 1971;26(6):411-25.)
  • (12) Api O, Akıl A, Güray Uzun M, Can E, Kaymaz Ö, Geçer M, Turan C, Ünal O. A Pregnancy Complicated By A Giant Placental Chorioangioma: Case Report, Turkiye Klinikleri J Gynecol Obst 2009;19:371-5.
  • (13) Marchetti AA. A consideration of certain types of benign tumors of the placenta. Surg Gynecol Obstet 1939;68:733–743.
  • (14) Escribano D, Galindo A, Arbues J, Puente JM, De la Fuente P. Prenal management of placental chorioangioma: value of the middle cerebral artery peak systolic velocity. Fetal Diagn Ther 2006;21:489–493.
  • (15) Sivaslı E, Tekşam Ö, Haliloğlu M, Güçer Ş, Orhan D, Gürgey A, Tekinalp G. Hydrops fetalis associated with chorioangioma and thrombosis of umbilical vein. The Turkish Journal of Pediatrics 2009; 51: 515-518
  • (16) 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.
  • (17) Wanapirak C, Tongsong T, Sirichotiyakul S, Chanprapapah P. Alcoholization: the choice of intrauterine treatment for chorioangioma. J Obstet Gynaecol Res 2002;28:71–5.
  • (18) Deren O, Ozyuncu O, Onderoglu LS, Durukan T. Alcohol injection for the intrauterine treatment of chorioangioma in a pregnancy with transfusion resistant fetal anemia: a case report. Fetal Diagn Ther 2007;22:203–5.
  • (19) Sepulveda W, Wong A, 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.

Plasental koryoanjioma: olgu sunumu

Year 2014, Volume: 45 Issue: 4, 165 - 170, 19.08.2014

Abstract

Plasental koryoanjiomalar, plasentanın en sık rastlanan bening tümörüdür. Olgumuz 30 yaşında G2 P1, 22. gebelik haftasında, yüksek Maternal Serum Alfa-Fetoprotein (MSAFP) sebebi ile perinatoloji polikliniğine refere edilmiştir. Ultrasonografik değerlendirmede; plasenta uterus sol posteriorda olup, lateralinde arteriyo-venöz vaskülarizasyon izlenen, 40x38 mm boyutlarında solid görünümlü kitle tespit edildi. Fetusta anomali saptanmadı. Plasental koryoanjioma ön tanısı ile gebelik takibe alındı. Gebeliğin 32. haftasında kitlenin boyutlarının 64x54 mm olduğu ve polihidroamniyosun eşlik ettiği tespit edildi. Yapılan Doppler ultrasonografide umbilikal arterde end-diyastolik akım kaybı olması nedeniyle  gebe hospitalize edildi. Maternal steroid uygulaması ile fetal akciğer matürasyonu takiben, sezeryan öyküsü nedeniyle sezeryan ile doğurtuldu. Plasentanın patolojik incelemesinde  koryoanjioma tanısı doğrulandı. Sonuçta, maternal serum AFP yüksekliği tespit edilen olgular, ultrasonografi ile korianjiom açısından değerlendilmelidir. Plasental koryoanjioma tespit edilen gebeler olası yüksek fetal ve maternal komplikasyonlar nedeniyle yakın takip edilmelidir. 

Anahtar kelimeler: Maternal Serum Alfa-Fetoprotein, Koryoanjioma, Doppler  Ultrasonografi

References

  • (1) Benirschke K, Kaufmann P, Baergen RN. Benign tumors and chorangiosis. In Pathology of Human Placenta (5th ed), Benirschke K, Kaufmann P (eds). Springer: New York, 2006. pp 863–76.
  • (2) Sepulveda W, Alcalde JL, Schnapp C, Bravo M. Perinatal outcome after prenatal diagnosis of placental chorioangioma. Obstet Gynecol 2003;102:1028–33.
  • (3) Fox H, Sebire NJ. Non-trophoblastic tumors of the placenta. In Pathology of the Placenta (3rd edn), Fox H, Sebire N (eds). Saunders Elsevier: Philadelphia, 2007. pp 401–30.
  • (4) Quarello E, Bernard JP, Leroy B, Ville Y. Prenatal laser treatment of a placental chorioangioma. Ultrasound Obstet Gynecol. 2005;25:299–301.
  • (5) Zanardini C, Papageorghiou A, Bhide A, Thilaganathan B. Giant placental chorioangioma: natural history and pregnancy outcome. Ultrasound Obstet Gynecol 2010;35:332–6.
  • (6) Knoth M, Rygaard J, Hesseldahl H. Chorioangioma with hydramnios and intrauterine fetal death. Acta Obstetricia at Gynaecologica Scandinavica 1990;55:279-281.
  • (7) Froehlich LA, Fujikura T, Fisher P. Chorioangiomas and their clinical implications. Obstet Gynecol 1971;37:51–59.
  • (8) Moncusa A, D’Anna R, Corrado F, Cannata M. Large placental choriangioma. Acta Obstet Gynecol Scand 2001;80:965-966.
  • (9) Bromley B, Benacerraf BR. Solid masses on the fetal surface of the placenta: differential diagnosis and clinical outcome. J Ultrasound Med 1994;13:883–886.
  • (10) Zalel Y, Weisz B, Gamzu R, Schiff E, Shalmon B, Achiron R. Chorioangiomas of the placenta: sonographic and Doppler flow characteristics. J Ultrasound Med. 2002;21:909-13.
  • (11) Wallenburg HCS. Chorioangioma of the placenta. Thirteen new cases and a review of the literature from 1939 to 1970 with special reference to the clinical complications. Obstet Gynecol Surv 1971;26(6):411-25.)
  • (12) Api O, Akıl A, Güray Uzun M, Can E, Kaymaz Ö, Geçer M, Turan C, Ünal O. A Pregnancy Complicated By A Giant Placental Chorioangioma: Case Report, Turkiye Klinikleri J Gynecol Obst 2009;19:371-5.
  • (13) Marchetti AA. A consideration of certain types of benign tumors of the placenta. Surg Gynecol Obstet 1939;68:733–743.
  • (14) Escribano D, Galindo A, Arbues J, Puente JM, De la Fuente P. Prenal management of placental chorioangioma: value of the middle cerebral artery peak systolic velocity. Fetal Diagn Ther 2006;21:489–493.
  • (15) Sivaslı E, Tekşam Ö, Haliloğlu M, Güçer Ş, Orhan D, Gürgey A, Tekinalp G. Hydrops fetalis associated with chorioangioma and thrombosis of umbilical vein. The Turkish Journal of Pediatrics 2009; 51: 515-518
  • (16) 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.
  • (17) Wanapirak C, Tongsong T, Sirichotiyakul S, Chanprapapah P. Alcoholization: the choice of intrauterine treatment for chorioangioma. J Obstet Gynaecol Res 2002;28:71–5.
  • (18) Deren O, Ozyuncu O, Onderoglu LS, Durukan T. Alcohol injection for the intrauterine treatment of chorioangioma in a pregnancy with transfusion resistant fetal anemia: a case report. Fetal Diagn Ther 2007;22:203–5.
  • (19) Sepulveda W, Wong A, 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.
There are 19 citations in total.

Details

Primary Language Turkish
Journal Section OBSTETRICS AND GYNECOLOGY
Authors

Pınar Kumru

Cem Ardıç

Oya Demirci

Oya Pekin This is me

Murat Muhcu

Ahmet Tuğrul

Cuma Yorgancı This is me

Publication Date August 19, 2014
Published in Issue Year 2014 Volume: 45 Issue: 4

Cite

APA Kumru, P., Ardıç, C., Demirci, O., Pekin, O., et al. (2014). Plasental koryoanjioma: olgu sunumu. Zeynep Kamil Tıp Bülteni, 45(4), 165-170. https://doi.org/10.16948/zktb.06418
AMA Kumru P, Ardıç C, Demirci O, Pekin O, Muhcu M, Tuğrul A, Yorgancı C. Plasental koryoanjioma: olgu sunumu. Zeynep Kamil Tıp Bülteni. October 2014;45(4):165-170. doi:10.16948/zktb.06418
Chicago Kumru, Pınar, Cem Ardıç, Oya Demirci, Oya Pekin, Murat Muhcu, Ahmet Tuğrul, and Cuma Yorgancı. “Plasental Koryoanjioma: Olgu Sunumu”. Zeynep Kamil Tıp Bülteni 45, no. 4 (October 2014): 165-70. https://doi.org/10.16948/zktb.06418.
EndNote Kumru P, Ardıç C, Demirci O, Pekin O, Muhcu M, Tuğrul A, Yorgancı C (October 1, 2014) Plasental koryoanjioma: olgu sunumu. Zeynep Kamil Tıp Bülteni 45 4 165–170.
IEEE P. Kumru, C. Ardıç, O. Demirci, O. Pekin, M. Muhcu, A. Tuğrul, and C. Yorgancı, “Plasental koryoanjioma: olgu sunumu”, Zeynep Kamil Tıp Bülteni, vol. 45, no. 4, pp. 165–170, 2014, doi: 10.16948/zktb.06418.
ISNAD Kumru, Pınar et al. “Plasental Koryoanjioma: Olgu Sunumu”. Zeynep Kamil Tıp Bülteni 45/4 (October 2014), 165-170. https://doi.org/10.16948/zktb.06418.
JAMA Kumru P, Ardıç C, Demirci O, Pekin O, Muhcu M, Tuğrul A, Yorgancı C. Plasental koryoanjioma: olgu sunumu. Zeynep Kamil Tıp Bülteni. 2014;45:165–170.
MLA Kumru, Pınar et al. “Plasental Koryoanjioma: Olgu Sunumu”. Zeynep Kamil Tıp Bülteni, vol. 45, no. 4, 2014, pp. 165-70, doi:10.16948/zktb.06418.
Vancouver Kumru P, Ardıç C, Demirci O, Pekin O, Muhcu M, Tuğrul A, Yorgancı C. Plasental koryoanjioma: olgu sunumu. Zeynep Kamil Tıp Bülteni. 2014;45(4):165-70.