Large Placental Chorangioma with an Unusual Uneventful Course

Abstract

Abstract

Background:

Placental chorangioma is a rare benign placental lesion associated with a multitude of fetomaternal or neonatal complications. Though it is the most common benign condition of the placenta, a chorangioma measuring >5 cm is very rare and leads to various clinically significant consequences.

Case:

This article presents the case of a 34-year-old multiparous woman, with no significant medical or obstetric history and with an unremarkable clinical status, who was diagnosed with a chorangioma (≈ 12 cm) at 32 weeks of pregnancy by ultrasonography and kept for observation for the rest of the gestation. A few weeks later, she had premature labor and delivered a male child uneventfully via a normal vaginal delivery. The delivered placenta had a well-defined lobular mass on the fetal surface, measuring 12 cm in its greatest diameter and located near the insertion of the umbilical cord. The placenta was intact and complete, and the outer surface of the mass was congested with prominent vascular markings.

Results:

On microscopy, multiple sections from the mass were examined showing numerous dilated vascular channels surrounded by placental stroma and pools of blood seen in few cavernous spaces. Sections from the umbilical cord were unremarkable. The histology results, therefore, confirmed the diagnosis of a chorangioma.

Conclusions:

Despite the clinically significant size of the chorangioma, prematurity was the only complication seen in this case. Still, these lesions should be viewed with caution, as location and vascularity are now increasingly identified as crucial factors in prognosis. Therefore, careful examination of the placenta, timely antenatal diagnosis, and early intervention should be given due emphasis, so that associated morbidity and mortality to both the fetus and the mother can be prevented. (J GYNECOL SURG 33:30)