Teenage Pregnancy with Chorioangioma: A Case Report with a Review on the Recent Trends on its Diagnosis and Management

Authors

  • Sufia Athar Department of Obstetrics and Gynecology, Al Wakra Hospital, HMC, Qatar
  • Yousra Shehada Siam Department of Obstetrics and Gynecology, Al Wakra Hospital, HMC, Qatar

DOI:

https://doi.org/10.31907/2309-4400.2020.08.02

Keywords:

Choriongiomas, tumors, fetal medicine unit, complications, interventions.

Abstract

 Placental Chorioangiomas are rare placental tumors. They are often not diagnosed until delivery or till the onset of complications. A review of the literature reveals a wide spectrum of the presenting features and its associated complications. Usually, large tumors are associated with maternal and fetal complications. Recent advances in the diagnosis and management of these tumors have been worthwhile in cases associated with complications. Current advances in the management of large Chorioangiomas are noteworthy in cases of extreme prematurity as the timing of delivery is a challenge in such scenarios. However, the timing of delivery has to be individualized. Due to atypical presentation and unpredictable manifestations of Chorioangiomas, prompt diagnosis and timed follow up is mandatory in all cases. Though these tumors are usually associated with increased maternal age, we report a case of teenage pregnancy with Chorioangioma and its management.

References

Amer HZ, Heller DS. Chorangioma and related vascular lesions of the placenta — a review. Fetal and Pediatric Pathology 2010; 29(4): 199-206. https://doi.org/10.3109/15513815.2010.487009

Al Wattar B, Hillman S, Marton T, Foster K, Kilby M. Placenta chorioangioma: a rare case and systematic review of literature. The Journal of Maternal-Fetal & Neonatal Medicine 2013; 27(10): 1055-1063. https://doi.org/10.3109/14767058.2013.847424

Zanardini C, Papageorghiou A, Bhide A, Thilaganathan B. Giant placental chorioangioma: natural history and pregnancy outcome. Ultrasound in Obstetrics and Gynecology 2010; 35(3): 332-336. https://doi.org/10.1002/uog.7451

Amala S, Veena N, Abdulla D, Nawal D. A Large Placental Chorioangioma with Good Perinatal Outcome. Bahrain Med Bull 2019; 41(2): 115-118.

Kirkpatrick AD, Podberesky DJ, Gray AE, et-al. Best Cases from the AFIP: Placental Chorioangioma. Radiographics 2007; 27(4): 1187-90. https://doi.org/10.1148/rg.274065207

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; 2012: 1-3. https://doi.org/10.1155/2012/913878

Mineyko A, Kirton A. The Black Box of Perinatal Ischemic Stroke Pathogenesis. Journal of Child Neurology 2011; 26(9): 1154-1162. https://doi.org/10.1177/0883073811408312

Ghidini A, Locatelli A. Diffuse placental chorioangiomatosis causing multiple fetal cerebral embolism: a case report. J Reprod Med 2006; 51: 321-4.

Das S, Ankola P, Chiechi M, Sandhu J. Perinatal Cerebral Arterial Infarction Associated with a Placental Chorioangioma. American Journal of Perinatology 2008; 25(6): 381-383. https://doi.org/10.1055/s-2008-1078755

Lehman L, Rivkin M. Perinatal Arterial Ischemic Stroke: Presentation, Risk Factors, Evaluation, and Outcome. Pediatric Neurology 2014; 51(6): 760-768. https://doi.org/10.1016/j.pediatrneurol.2014.07.031

Imdad A, Sheikh L, Malik A. A large chorioangiomas causing intrauterine foetal demise. J Pak Med Assoc 2009; 59: 580-1.

Reshetnikova O, Burton G, Milovanov A, Fokin E. Increased incidence of placental chorioangioma in high-altitude pregnancies: Hypobaric hypoxia as a possible etiologic factor. American Journal of Obstetrics and Gynecology 1996; 174(2): 557-561. https://doi.org/10.1016/S0002-9378(96)70427-1

Taori K, Patil P, Attarde V, Singh A, Rangankar V. Chorioangioma of placenta: Sonographic features. Journal of Clinical Ultrasound 2008; 36(2): 113-115. https://doi.org/10.1002/jcu.20366

Lurain J. Gestational trophoblastic disease I: epidemiology, pathology, clinical presentation and diagnosis of gestational trophoblastic disease, and management of hydatidiform mole. American Journal of Obstetrics and Gynecology 2010; 203(6): 531-539. https://doi.org/10.1016/j.ajog.2010.06.073

Gimenez A, Kopkin R, Chang D, Belfort M, Reece E. Advances in Fetal Surgery: Current and Future Relevance in Plastic Surgery. Seminars in Plastic Surgery 2019; 33(03): 204-212. https://doi.org/10.1055/s-0039-1693431

Wu Z, Hu W. Clinical analysis of 26 patients with histologically proven placental chorioangiomas. European Journal of Obstetrics & Gynecology and Reproductive Biology 2016; 199: 156-163. https://doi.org/10.1016/j.ejogrb.2015.12.009

Dong T, Sher D, Luo Q. Pregnancy complications and adverse outcomes in placental chorioangioma: a retrospective cohort analysis. The Journal of Maternal-Fetal & Neonatal Medicine 2018; 1-5. https://doi.org/10.1080/14767058.2018.1548598

Quintero R, Reich H, Romero R, Johnson M, Gonçalves L, Evans M. In utero endoscopic devascularization of a large chorioangioma. Ultrasound in Obstetrics and Gynecology 1996; 8(1): 48-52. https://doi.org/10.1046/j.1469-0705.1996.08010048.x

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(8): 909-13. https://doi.org/10.7863/jum.2002.21.8.909

Ercan C, Coksuer H, Karasahin K, Alanbay I, Baser I. Combined Approach in a Large Placental Chorioangioma Case with Intratumoral Alcohol Injection, Cordocentesis, IU Transfusion, and Amnioreduction. Fetal and Pediatric Pathology 2012; 31(6): 374-378. https://doi.org/10.3109/15513815.2012.659402

Hamouda S, Soussan J, Haumonté J, Bretelle F. In utero embolization for placental chorioangioma and neonatal multifocal hemangiomatosis. Journal of Gynecology Obstetrics and Human Reproduction 2019; 48(8): 689-694. https://doi.org/10.1016/j.jogoh.2019.05.011

Phithakwatchara N, Makarasen P, Nawapun K, Hanamornroongruang S, Viboonchart S, Wataganara T. Time and temperature dependence of radiofrequency ablation in the human placenta. Prenatal Diagnosis 2018; 38(7): 504-510. https://doi.org/10.1002/pd.5276

Hun K, Nassar P, Chen T, Sardesai S, Chmait R. Giant Chorioangioma TreatedIn Uterovia Laser of Feeding Vessels with Subsequent Development of Multifocal Infantile Hemangiomas. Fetal and Pediatric Pathology 2014; 34(1): 1- 8. https://doi.org/10.3109/15513815.2014.925018

Jones K, Tierney K, Grubbs B, Pruetz J, Detterich J, Chmait R. Fetoscopic Laser Photocoagulation of Feeding Vessels to a Large Placental Chorioangioma following Fetal Deterioration after Amnioreduction. Fetal Diagnosis and Therapy 2012; 31(3): 191-195. https://doi.org/10.1159/000331944

Kirstie M. Franceschina, Sonographic Evaluation of a Large Placental Chorangioma. Journal of Diagnostic Medical Sonography 2017; 33(3): 246-250. https://doi.org/10.1177/8756479317691357

Bashiri A, Furman B, Erez O, Wiznitzer A, Holcberg G, Mazor M. Twelve cases of placental chorioangioma, Pregnancy outcome and clinical significance. Arch Gynecol Obstet 2002; 266: 53-55. https://doi.org/10.1007/PL00007501

Wanapirak C, Tongsong T, Sirichotiyakul S, Chan-Prapaph P. Alcoholization: the choice of intrauterine treatment for chorioangioma. Journal of Obstetrics and Gynaecology Research 2002; 28(2): 71-75. https://doi.org/10.1046/j.1341-8076.2002.00016.x

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Published

2020-02-28

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