Placental chorioangioma

胎盘绒毛膜血管瘤
  • 文章类型: Case Reports
    巨大脉络膜血管瘤,尽管罕见,对胎儿和母体构成重大风险。当胎儿发生妥协时,及时和个性化的治疗计划对于降低发病率和死亡率至关重要。此外,成功的保守管理依赖于一致的超声监测,多普勒血流仪评估,和羊水水平测量。
    绒毛膜血管瘤是良性胎盘肿瘤,约占妊娠的1%。巨大脉络膜血管瘤,以肿瘤超过4厘米为特征,非常罕见,对孕产妇和胎儿健康构成重大风险。此病例报告详述了一名患有多发性巨大脉络膜血管瘤的患者,强调与这些肿瘤相关的罕见和相应的并发症。一个23岁的女人,G3P2,在28周胎龄时,被诊断为多发性大,明确的胎盘肿块,血管分布增加,指示巨大胎盘绒毛膜血管瘤。随后的超声显示各种胎儿异常,如腭裂和嘴唇,还有肺和心脏的异常.在妊娠34+5周,因先兆子痫行紧急剖宫产术.随后,一名女性新生儿出生时患有胎儿水肿。不幸的是,她在生命的第一个小时内就去世了。与脉络膜血管瘤相关的并发症主要来自动静脉分流,这可能导致胎儿灌注受损和心力衰竭。虽然小尺寸的脉络膜血管瘤经常偶然发现,多普勒超声和磁共振成像可以可靠地将这些肿瘤与其他胎盘病变区分开来。此外,针对胎龄和母胎症状的管理策略通常需要多学科方法。然而,额外的研究对于了解绒毛膜血管瘤的机制和制定综合治疗指南至关重要.
    UNASSIGNED: Giant chorioangiomas, despite being rare, pose significant fetal and maternal risks. Timely and individualized treatment plans are crucial to reduce morbidity and mortality when fetal compromise occurs. Additionally, successful conservative management relies on consistent ultrasound monitoring, Doppler flowmetry assessments, and amniotic fluid level measurements.
    UNASSIGNED: Chorioangiomas are benign placental tumors that manifest in approximately 1% of pregnancies. Giant chorioangiomas, characterized by tumors exceeding 4 cm, are exceptionally rare and pose substantial risks to maternal and fetal health. This case report details a patient with multiple giant chorioangiomas, emphasizing the rarity and consequential complications associated with these tumors. A 23-year-old woman, G3P2, at 28 weeks gestational age, was diagnosed with multiple large, well-defined placental masses with increased vascularity, indicative of giant placental chorioangiomas. Subsequent ultrasound revealed various fetal anomalies such as cleft palate and lip, as well as lung and heart abnormalities. At 34+5 weeks of gestation, an emergency cesarean section was performed due to preeclampsia. Subsequently, a female neonate was born with hydrops fetalis. Unfortunately, she passed away within the first hour of her life. Complications associated with chorioangiomas primarily arise from arteriovenous shunts, which potentially lead to compromised fetal perfusion and cardiac failure. Although small-sized chorioangiomas are often discovered incidentally, Doppler ultrasound and magnetic resonance imaging can reliably distinguish these tumors from other placental lesions. Additionally, management strategies tailored to gestational age and maternal-fetal symptoms typically necessitate a multidisciplinary approach. However, additional research is essential to understand the mechanisms of chorioangiomas and to develop comprehensive management guidelines.
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  • 文章类型: Review
    背景:胎盘绒毛膜血管瘤是一种罕见的妊娠期疾病。我们回顾性回顾了胎盘绒毛膜血管瘤妊娠的围产期并发症和长期结局,并评估了影响疾病预后的因素。
    方法:我们回顾了近十年来我院分娩并经病理诊断证实为胎盘绒毛膜血管瘤的孕妇。关于孕产妇人口统计数据的信息,通过查阅病历获得产前超声检查结果和围产期结局.在研究的后半部分,通过电话采访对儿童进行了随访。
    结果:在2008年8月至2018年12月的10年中,有175例(0.17%)在组织学上被确定为胎盘绒毛膜血管瘤,其中44例(0.04%)为大型绒毛膜血管瘤。近三分之一的大型脉络膜血管瘤病例与严重的母体和胎儿并发症或需要产前干预有关。尽管五分之一的胎儿/新生儿并发大脉络膜血管瘤在围生期丢失,存活胎儿的长期预后总体良好.进一步的统计分析表明,肿瘤的大小和位置会影响预后。
    结论:胎盘绒毛膜血管瘤可能导致不良的围产期结局。定期超声监测可以提供肿瘤特征,这些特征可以用于预测这些并发症的趋势并指示何时需要干预。尚不清楚哪些因素导致以胎儿损害为主要表现或以羊水过多为主要表现的并发症。
    BACKGROUND: Placental chorioangioma is a rare disorder in pregnancy. We retrospectively reviewed the perinatal complications and long-term outcomes in pregnancies with placental chorioangioma and evaluated the factors affecting disease prognosis.
    METHODS: We reviewed pregnant women who delivered at our hospital in the past decade and whose diagnosis of placental chorioangioma was confirmed by pathological diagnosis. Information on maternal demographics, prenatal sonographic findings and perinatal outcomes was obtained by reviewing the medical records. In the latter part of the study, follow-up of children was conducted by phone interview.
    RESULTS: In the 10 years from August 2008 to December 2018, 175 cases(0.17%) were identified as placental chorioangioma histologically and 44(0.04%) of them were large chorioangiomas. Nearly one-third of cases with large chorioangiomas were associated with severe maternal and fetal complications or required prenatal intervention. Although one-fifth of fetuses/newborns complicated with large chorioangiomas were lost perinatally, the long-term prognosis for surviving fetuses was generally good. Further statistical analysis revealed that tumor size and location affect prognosis.
    CONCLUSIONS: Placental chorioangioma may cause an unfavorable perinatal outcome. Regular ultrasound monitoring can provide the tumor characteristics which can be referred to for predicting the tendency of those complications and indicate when intervention may be necessary. It is not clear which factors lead to complications with fetal damage as the main manifestation or polyhydramnios as the main manifestation.
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  • 文章类型: Case Reports
    一名初产妇在妊娠25+1周时接受了胎儿镜激光光凝治疗,脉络膜血管瘤扩大至61×46×52毫米。然而,在妊娠32+2周时,绒毛膜血管瘤与胎盘分离,进行了剖宫产.由于脉络膜血管瘤的血液供应受阻,可以提供预期治疗。
    A primigravida received fetoscopic laser photocoagulation treatment at 25+1 weeks gestation as a chorioangioma enlarged to 61 × 46 × 52 mm. However, a cesarean section was performed due to the chorioangioma separated from the placenta at 32+2 weeks gestation. As the chorioangioma\'s blood supply were blocked, it was possible to provide expectant treatment.
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  • 文章类型: Case Reports
    与胎儿高动力循环并发症相关的巨大胎盘绒毛膜血管瘤很少见。这里,我们总结了一例巨大胎盘绒毛膜血管瘤合并胎儿贫血和心力衰竭的病例,该病例采用射频消融术(RFA)联合脐带穿刺术和宫内输血治疗.胎盘绒毛膜血管瘤的超声表现不典型,等回声,边界不清。在妊娠27周时成功进行了RFA,当绒毛膜血管瘤增加到17.0×10.6×12.3cm3时。不幸的是,术后第一天发现胎儿宫内死亡。引产后,经病理证实为胎盘绒毛膜血管瘤。
    Giant placental chorioangiomas associated with fetal hyperdynamic circulation complications are rare to see. Here, we summarized a case of giant placental chorioangioma associated with fetal anemia and heart failure treated by radiofrequency ablation (RFA) combined with cordocentesis and intrauterine transfusion. The sonographic appearance of the placental chorioangioma was atypical which was isoechoic with unclear boundary. RFA was performed successfully at 27 weeks of gestation, when the chorioangioma has increased to 17.0 × 10.6 × 12.3 cm3 . Unfortunately, intrauterine fetal demise was found on the first day after operation. After induction of labor, it was pathologically confirmed as placental chorioangioma.
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  • 文章类型: Case Reports
    未经证实:绒毛膜血管瘤的病因机制尚不清楚。在风险因素中,缺氧,环境和遗传因素被认为可以诱导促血管增殖的血管生成细胞因子的过度表达。我们报告了一例产前诊断为67毫米宽的胎盘绒毛膜血管瘤,发生在胎龄32周,梗塞,然后在胎龄35周时发生第二次梗塞性绒毛膜血管瘤。此外,我们通过文献综述讨论了脉络膜血管瘤的病因和行为假说。
    UNASSIGNED:我们在没有时间间隔的情况下对绒毛膜血管瘤病例进行了文献检索。因此,我们对脉络膜血管瘤的危险因素和病因进行了文献总结,通过在1995年至2021年的时间间隔内选择文章。
    UNASSIGNED:这是文献中发表的同一妊娠连续两次绒毛膜血管瘤的第一例。我们发现发生绒毛膜血管瘤的女性可能存在遗传易感性,而梗塞可能与肿瘤血管结构异常有关。第二个病变的发作可以反映梗塞后的缺氧刺激,并涉及缺氧诱导因子-1alpha,血管内皮生长因子,转化生长因子-β,和可溶性Fms样酪氨酸激酶-1途径。在易感个体中,脉络膜增生可以共存,并且可能反映出相互的病因。
    未经证实:易感胎盘,之前产生了绒毛膜血管瘤,绒毛膜血管瘤的梗塞不应代表终止妊娠的迹象,但更密切监测的标记,以早期发现第二绒毛膜血管瘤的可能发作和更高的脐带血栓形成风险。
    UNASSIGNED: Aetiopathogenesis of chorioangioma is already unknown. Among the risk factors, hypoxia, environmental and genetic factors are believed to induce the overexpression of angiogenic cytokines promoting vascular proliferation. We reported a case of prenatally diagnosed 67 mm-wide placental chorioangioma, which occurred at 32 weeks of gestational age, infarcted, and followed by the onset of a second infarcted chorioangioma at 35 weeks of gestational age. Besides, we discussed the hypothesis of chorioangioma aetiopathogenesis and behavior through a literature summary.
    UNASSIGNED: We carried out a literature search of chorioangioma cases without a time interval. Therefore, we carried out a literature summary on chorioangioma risk factors and etiology, by selecting articles within a time interval from 1995 to 2021.
    UNASSIGNED: This is the first case of two consecutive chorioangiomas in the same pregnancy published in the literature. We found a possible genetic predisposition in women developing chorioangioma while infarction may be related to the abnormal structure of tumor vessels. The onset of a second lesion could reflect hypoxic stimuli following infarction and involves hypoxia-induced factor-1alpha, vascular endothelial growth factor, transforming growth factor-beta, and soluble Fms-like tyrosine kinase-1 pathways. Chorangiosis can be coexistent and may reflect a mutual etiology in susceptible individuals.
    UNASSIGNED: In a predisposed placenta, that previously generated a chorioangioma, infarction of the chorioangioma should not represent a sign for pregnancy termination, but a marker for closer monitoring to early detect the possible onset of a second chorioangioma and a higher risk of umbilical cord thrombosis.
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  • 文章类型: Case Reports
    Chorioangiomas are the most common non-trophoblastic benign vascular tumor of the placenta, highly associated with perinatal death rate. Herewith, we are reporting the prenatal diagnosis, management and postnatal outcome of a fetus referred at 33 weeks gestation with massive cardiomegaly secondary to placenta chorioangioma.
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  • 文章类型: Case Reports
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  • 文章类型: Case Reports
    Background: Placental chorioangioma is the most common benign non-trophoblastic neoplasm of the placenta. Its clinical relevance lies in the size of the tumor since larger masses cause pregnancy complications, including an unfavorable neonatal outcome. Case presentation: We report the case of a 34-year-old second gravida and nullipara at the 35th week of gestation, admitted to the gynecological department for antibiotic-resistant fever. The cardiotocography performed during hospitalization showed an abnormal fetal pattern. A 2250 g newborn was delivered by cesarean section. No complications were observed during childbirth and postpartum was insignificant. On gross inspection a white fleshy intraparenchymal mass blooming on the maternal surface was noted; routinely stained sections revealed features consistent with chorioangioma with vascular channels lined by inconspicuous endothelial cells immunoreactive for CD31 and CD133. Focal expression of CD133 was also observed in placental villi. Discussion: CD133 expression indicated the presence of stem cells in chorioangioma, suggesting their possible role in the development of mesenchymal lesions including chorioangioma.
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  • 文章类型: Case Reports
    Placental chorioangioma (CA) is a benign placental tumor. No specific treatment is required for asymptomatic cases. We report a female infant born to a mother with giant placental CA. However fetal growth was normal and, fetal hydrops was not detected by ultrasound examination until delivery, she had hydrops, subgaleal hematoma, thrombocytopenia, hemolytic anemia, respiratory distress and circulatory failure after birth. She was successfully treated without any neurological sequelae. At 2 months of age, infantile hemangioma appeared in her lower lip. The present case suggested that giant placental CA might cause postnatal problems and be associated with the development of infantile hemangioma.
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  • 文章类型: Case Reports
    A pregnant woman was referred to our hospital due to fetal cardiomegaly. We recognised a dilated umbilical vein, which raised a suspicion of placental chorioangioma. A male neonate was delivered at 37 weeks of gestation. The cardiomegaly was gradually improved. Pathological examination identified five non-giant placental chorioangiomas. Multiple non-giant chorioangiomas may cause fetal complications despite the difficulty of prenatal diagnosis.
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