Mayday University Hospital, Croydon, Surrey, UK.
Arch Gynecol Obstet. 2011 Mar;283 Suppl 1:15-7. doi: 10.1007/s00404-010-1606-y. Epub 2010 Aug 1.
Umbilical cord tumors are extremely rare with hemangiomas and teratomas accounting for the most common tumors.
A 26-year-old woman had an anomaly scan at 22 weeks. There was an echogenic area in the umbilical cord, the mass, which appeared enlarged and oedematous findings represented an umbilical cord hemangioma, but no fetal abnormalities (Fig. 1). The second ultrasound examination for follow-up showed that the fetus was dead. The macerating fetus (46XY) weighing 650 g was autopsied, and the report confirmed umbilical cord hemangioma and no significant congenital abnormalities (Figs. 2, 3).
A high perinatal mortality and morbidity rate has been reported with hemangiomas of umbilical cord. Impaired umbilical circulation is considered as the predisposing factor for fetal demise. It is associated with premature delivery, cardiac failure, severe fetal hemorrhage, IUGR and intrauterine death. The differential diagnosis of umbilical cord hemangioma should include hematomas, varices, aneurysms, thrombosis and tumors. Close antenatal follow-up is mandatory, with serial USS examinations, which should involve AFI, tumor size and Doppler studies. The examination should be at 4 weeks intervals up to 32-34 weeks and every 1-2 weeks thereafter depending on the findings.
The prenatal diagnosis of umbilical cord hemangioma should be suspected when an echogenic mass is visualized within the umbilical cord.
脐带肿瘤极为罕见，其中血管瘤和畸胎瘤最为常见。
一名 26 岁女性在 22 周时进行了异常扫描。脐带内有一个高回声区，即肿块，看起来增大且水肿，提示为脐带血管瘤，但胎儿无异常（图 1）。第二次超声检查随访显示胎儿已死亡。对木乃伊化胎儿（46XY）进行尸检，重量为 650 克，报告证实为脐带血管瘤，无明显先天性异常（图 2、3）。
脐带血管瘤的围产期死亡率和发病率较高。脐带循环受损被认为是胎儿死亡的诱发因素。它与早产、心力衰竭、严重胎儿出血、胎儿生长受限和宫内死亡有关。脐带血管瘤的鉴别诊断应包括血肿、静脉曲张、动脉瘤、血栓形成和肿瘤。必须进行密切的产前随访，包括定期进行 USS 检查，包括 AFI、肿瘤大小和多普勒研究。检查应在 4 周间隔进行，直至 32-34 周，此后根据检查结果每 1-2 周进行一次。
当在脐带内观察到回声肿块时，应怀疑脐带血管瘤的产前诊断。
