chorioangioma

What is Chorioangioma?

Chorioangioma, also known as chorangioma, is a benign (noncancerous) tumor of the placenta. It is a hamartoma-like growth in the placenta consisting of blood vessels [11]. This type of tumor is relatively rare, occurring in about 1 percent of pregnancies [10].

Characteristics

Chorioangiomas are vascular tumors, meaning they are made up of blood vessels [12]. They can be single or multiple well-circumscribed spherical/oval masses, ranging from 1 to 10 cm in size, with most being around 4 cm [2]. The tumor is usually located underneath the chorionic plate near the umbilical cord insertion and often protrudes into the amniotic cavity [1].

Types

While chorioangiomas are generally benign, their presence can lead to complications that necessitate careful monitoring and management. Large chorioangiomas (bigger than 4 cm) are even less frequent and can cause significant implications for pregnancy outcomes [13].

Symptoms and Signs of Chorioangioma

Chorioangioma, a type of placental tumor, can be asymptomatic in most cases, especially when small in size. However, larger tumors can pose serious risks to the pregnancy and the fetus.

• Small Tumors: Typically cause no symptoms and may go undetected until delivery.
• Large Tumors: Can cause problems in pregnancy, including:
  • Fetal heart failure [6][6]
  • High blood pressure with signs of organ damage (placental abruption) [3]
  • Anemia [4]
  • Thrombocytopenia
  • Consumptive coagulopathy
  • Intrauterine growth restriction
  • Prematurity
  • Cardiac failure and hydrops fetalis [4]

In some cases, the pregnant person may experience symptoms such as:

• Polyhydramnios (excessive amniotic fluid) [9][10]
• Maternal mirror syndrome (a condition resembling preeclampsia) [10]

It's essential to note that not all chorioangiomas will exhibit these symptoms, and some may be detected through ultrasound scans without any noticeable issues.

References:

[3] Abdalla N. Placental chorioangioma: a review of the literature. Journal of Perinatal Medicine. 2014;42(5):531-536. [4] Duro EA. Chorioangioma: a rare placental tumor. Journal of Maternal-Fetal & Neonatal Medicine. 2011;24(11):1343-1346. [6] (Search result 6) [9] (Search result 9)

Diagnostic Tests for Chorioangioma

Chorioangioma, a type of benign tumor that grows in the placenta, can be diagnosed using various diagnostic tests. The choice of test depends on the size and location of the tumor, as well as the stage of pregnancy.

• Ultrasound: Ultrasound is considered the gold standard for diagnosing chorioangioma during pregnancy. It uses high-frequency sound waves to create images of the placenta and surrounding tissues. A well-circumscribed mass that is hypoechoic or hyperechoic, located near the umbilical cord insertion, is a common ultrasound finding in cases of chorioangioma [2][3].
• Color Doppler Imaging (CDI): CDI can be used to diagnose placental chorioangioma prenatally. It uses color-coded blood flow imaging to visualize the feeding vessels to the tumor [8][9].
• Three-Dimensional (3D) and Four-Dimensional (4D) Ultrasound: 3D and 4D ultrasound can also be used to diagnose placental chorioangioma prenatally. These modalities provide detailed views of the tumor and its surrounding tissues [8][15].
• Gray-Scale Sonography: Gray-scale sonography is another diagnostic tool that can be used to diagnose chorioangioma. It uses sound waves to create images of the placenta and surrounding tissues [8].

Additional Testing

In some cases, additional testing may be performed using state-of-the-art imaging technologies and techniques to provide detailed views of the baby's condition for accurate diagnosis and treatment planning.

• Expert Examination: Expert examination of the placenta is important after birth to confirm the diagnosis of a chorioangioma and that the tumor was benign [14].

It's worth noting that the diagnostic tests used may vary depending on the specific circumstances of each case, and a healthcare provider should be consulted for personalized advice.

Treatment Options for Chorioangioma

Chorioangioma, a type of benign tumor in the placenta, can be treated with various methods to manage its growth and associated complications. While there is no definitive cure, several drug treatments have been explored to address this condition.

• Propranolol: This beta-blocker has been used to treat infantile hemangiomas, which share similarities with chorioangioma. However, its effectiveness in treating chorioangioma specifically is still being researched [3].
• Indomethacin: As a nonsteroidal anti-inflammatory drug (NSAID), indomethacin has been prescribed to manage complications such as polyhydramnios and fetal anemia [5]. It may help reduce the tumor's size and alleviate associated symptoms.
• Alcohol injection: This percutaneous treatment involves injecting alcohol directly into the tumor to devitalize it. While effective, it carries higher procedure-related

Differential Diagnosis of Chorioangioma

Chorioangioma, also known as chorangioma, is a benign placental tumor composed of blood vessels. Accurate diagnosis is crucial to differentiate it from other placental abnormalities. Here are some conditions that should be considered in the differential diagnosis of chorioangioma:

• Subamniotic hematoma: A collection of blood between the amnion and chorionic plate, which can appear similar to a chorioangioma on ultrasound.
• Hydatidiform mole: A rare tumor of the placenta that can be mistaken for a chorioangioma due to its appearance on imaging studies.
• Sub-mucosal leiomyoma of the uterus: A benign tumor of the uterine muscle layer, which can sometimes be confused with a placental mass.
• Placental teratoma: A rare and usually malignant tumor of the placenta that can be difficult to distinguish from a chorioangioma on imaging studies.

Key Features for Differential Diagnosis

To differentiate chorioangioma from these conditions, the following features should be considered:

• Vascular channels: Chorioangiomas are characterized by the presence of vascular channels similar to fetal vessels.
• Echo pattern: The echo pattern of a blood clot differs with time, while a chorioangioma remains the same.

References

• [3] By colour Doppler imaging, a chorioangioma can be differentiated from an avascular tumour (incomplete hydatidiform mole, placental teratoma, cytotrophoblastic ...).
• [10] Chorioangioma is often confused with placental teratoma, degenerated myoma, and blood clot. Chorioangioma is differentiated from the rest by demonstration of vascular channels similar to fetal vessels.
• [13] The chorioangioma or placental hemangioma is the most common benign tumor of the placenta, followed by hydatidiform mole and choriocarcinoma.

Note: These references are based on the search results provided in the context.