Placental Chorioangioma

Chorioangioma is a primary benign tumour with predominantly vascular involvement. It is found in 1% of all placentas undergoing careful and systematic histopathological examination. A rarer form is the clinically relevant chorioangioma which is likely to be associated with complications like polyhydramnios, pre-term birth, IUGR, anemia, fetal congested heart decompensation, non-immune fetal hydrops, perinatal mortality. Chorioangioma generally presents an increased consistency compared to adjacent tissues; it tends to be single, rounded and reddish-brown in colour. The preferred localisation is on the fetal side of the placental disk and it may protrude into the amniochorial cavity; the volume is variable (but rarely exceeds a maximum diameter of 4-5 cm). Of the known 3 histotypes of chorioangioma (angiomatous, cellular, degenerative), the first is the most insidious: the intratumoral vascular bed represents an arteriovenous shunt in the systematic circulation of the fetus #150; sometimes causing dramatic hemodynamic consequences #150; as well as a functional empty space (blood short-circuited through the neoplasm circulation would be deprived of the possibility of adequate gaseous and metabolic exchanges at the level of the terminal villi). Having been identified as early as 1798, chorioangioma has recently been the subject of renewed interest for the following reasons: 1) the possibility of prenatal diagnosis, prohibited to earlier generations of authors, following the development of instrumental techniques like ultrasonography and flowmetry; 2) the acquisition of new knowledge regarding the physiopathology of the tumour and the etiopathogenesis of its main complications; 3) improved prognostic capacity accompanied by better prospects for correct management; 4) wider awareness of the range of therapeutic options available.