Placental chorioangioma

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[edit] Discussion of Placental chorioangioma

  • Placental chorioangioma is the most common tumor of the placenta
  • Most chorioangiomas are small and are found incidentally at screening obstetric US examinations.
  • Most authors categorize chorioangiomas as neoplasms; however, there is some debate as to whether they are actually hamartomas, given their composition of mostly native placental tissue and their inability to metastasize.
  • Although most chorioangiomas are asymptomatic, large or multiple chorioangiomas have a dismal prognosis due to their high association with maternal and fetal complications, which include polyhydramnios, preterm labor, fetal hemolytic anemia, fetal thrombocytopenia, cardiomegaly, intrauterine growth restriction, toxemia, placental abruption, preeclampsia, and congenital abnormalities.
  • The pathophysiology of maternal and fetal complications is not well understood.

  • Chorioangioma is usually treated with expectant management, as the majority of tumors are asymptomatic.
  • Small tumors are usually monitored with US every 6–8 weeks, whereas large tumors require serial US examinations every 1–2 weeks.

[edit] Imaging Findings for Placental chorioangioma

[edit] US

At gray-scale imaging, chorioangioma is a hypo- or hyperechoic circumscribed mass that is distinctly different from the placenta and contains anechoic cystic areas.

  • The tumor classically protrudes into the amniotic cavity from the fetal surface near the cord insertion.
  • On color Doppler images, the anechoic cystic areas demonstrate pulsatile flow on spectral analysis, a finding consistent with vascular channels within the tumor.
  • Large chorioangiomas may undergo spontaneous infarction with decreased echogenicity, decreased tumor volume, and decreased blood flow on color Doppler images.

[edit] MRI

  • MR imaging findings for chorioangioma include a heterogeneous mass with high T2 signal intensity, an appearance similar to that of a hemangioma.

[edit] Images

Patient #1

[edit] See Also

[edit] External Links

[edit] References for Placental chorioangioma