Chorioangioma

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Chorioangioma
Placenta with 10cm chorioangioma.jpg
Synonyms Placental hemangioma
Pronounce N/A
Specialty N/A
Symptoms Often asymptomatic, but can include polyhydramnios, fetal growth restriction, fetal anemia, hydrops fetalis
Complications Preterm birth, fetal demise
Onset During pregnancy
Duration Varies
Types N/A
Causes Unknown
Risks Large size, multiple tumors
Diagnosis Ultrasound, Doppler ultrasound
Differential diagnosis Placental abruption, molar pregnancy
Prevention None
Treatment Monitoring, amnioreduction, intrauterine transfusion
Medication N/A
Prognosis Depends on size and complications
Frequency Rare
Deaths N/A


Chorangioma - low magnification

Chorioangioma is a benign tumor that develops from the placenta during pregnancy. It is the most common non-trophoblastic tumor of the placenta, although it is still relatively rare, occurring in approximately 1% of pregnancies. Chorioangiomas are typically small and asymptomatic, but larger tumors can lead to complications for both the mother and the fetus.

Causes

The exact cause of chorioangioma is unknown. However, it is believed to be related to abnormal development of the blood vessels in the placenta. Some studies have suggested that maternal factors such as age, race, and parity may influence the risk of developing chorioangioma, but these findings are not consistent across all studies.

Symptoms

Most chorioangiomas are small and do not cause any symptoms. However, larger tumors can lead to a variety of complications, including:

  • Polyhydramnios: This is a condition in which there is too much amniotic fluid in the amniotic sac. It can lead to preterm labor and other complications.
  • Fetal anemia: The tumor can divert blood flow away from the fetus, leading to anemia.
  • Fetal growth restriction: The tumor can interfere with the transfer of nutrients from the mother to the fetus, leading to slow growth.
  • Fetal heart failure: In severe cases, the tumor can put a strain on the fetus's heart, leading to heart failure.

Diagnosis

Chorioangioma can be diagnosed during pregnancy using ultrasound imaging. The tumor appears as a well-defined mass in the placenta. In some cases, additional imaging techniques such as MRI may be used to confirm the diagnosis.

Treatment

The treatment for chorioangioma depends on the size of the tumor and the severity of the symptoms. Small, asymptomatic tumors may not require any treatment. For larger tumors, treatment options may include:

  • Fetal surgery: In some cases, it may be possible to remove the tumor surgically.
  • Embolization: This is a procedure in which the blood supply to the tumor is blocked, causing it to shrink.
  • Delivery: If the tumor is causing severe complications, it may be necessary to deliver the baby early.

Prognosis

The prognosis for chorioangioma depends on the size of the tumor and the severity of the symptoms. Small, asymptomatic tumors generally have a good prognosis. However, larger tumors can lead to serious complications and may require early delivery.

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Contributors: Prab R. Tumpati, MD