Giant placental chorioangioma: A rare case report.

INTRODUCTION AND IMPORTANCE

Chorioangioma is benign, non-trophoblastic vascular neoplasms of the placenta with an estimated incidence of 1 %. It originates from placental blood vessels. Giant chorioangiomas, larger than 4 cm in diameter, are rare with an incidence ranging between 1/3500 and 1/9000 pregnancies. Giant chorioangiomas easily detected by prenatal ultrasound and are associated with a series of pregnancy and fetal complications.

CASE PRESENTATION

A 34-year-old multigravida woman, with twin pregnancy presented with notation of reduced fetal movement. On sonographic examination, first fetus was Intrauterine Growth Restriction (IUGR), stage 1 and the second fetus was small-for gestational age and a well-defined, hypoechoic lesion with increased vascularity measuring 5.8 × 4.7 × 2.5 cm on the fetal surface of the placenta was seen. However, at 35 + 3 weeks, the patient presented with pain in the lower abdomen. Maternal vital signs were within normal ranges. On Physician team discussion, cesarean section was performed. Two female neonates weighing 2260 g and 2400 g were delivered, with normal APGAR scores and physical examinations. And physical examination. The placenta was sent to pathology laboratory. In histopathology numerous proliferative blood vessels was found that confirm with immunohistochemical analysis. Finally, the patient was diagnosed with placental chorioangioma.

DISCUSSION

Placental chorioangioma is a rare anomaly in villous capillary development, with uncertain pathogenesis. It is often linked to twin pregnancies, gestational diabetes, maternal hypertension, and female fetal sex. Prenatal sonographic scans are valuable for its identification, revealing a hypoechoic, highly vascular mass confirmed via Doppler ultrasound. In contrast, chorangiocarcinoma, a malignant placental tumor, comprises chorioangioma and proliferating trophoblast cells with distinct histological features. Close monitoring and sonographic evaluations are vital during pregnancy when managing chorioangioma, especially giant ones, known to cause various fetal and pregnancy complications. The decision-making process for delivery in cases of giant chorioangioma should consider fetal complications and gestational age. While some interventions like laser ablation are available, the challenging nature of the patient's response may warrant conservative management in certain instances.

CONCLUSION

We report a rare case of giant placental chorioangioma in a 34-year-old twin pregnant patient. Chorioangioma benign vascular neoplasms of the placenta may cause pregnancy and fetal complications.