Teaching File- Chorioangioma
​What you need to know

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Take Home Points

what is a chorioangioma and what are the diagnostic features?

• Most common benign placental neoplasm
• Usually solid, but can have cystic components
• Almost invariably occur near the placental cord insertion
• Tend to bulge outward, but as in this case, can also be intra-placental

what are the clinical implications?

• Why do we care about a benign placental tumor??
• Since these lesions are composed of capillaries surrounded by stroma, they can develop arterio-venous fistulae. 
• Key Point: The vascular supply of these lesions are supplied by the fetal circulation
• If large or AV fisulta, a high flow state can ensue and because they are supplied by the fetal circulation, this can put stress on the fetal cardiovascular system (e.g/ hydrops, poly, etc)

what is the management?

• Fortunately, the outcome is generally excellent. 
• However, caution is important and it is reasonable to follow these closely (q 7-10 days) initially to assess for the development of fetal complications. As time progresses, the follow-up interval can be increased. 
  

Differential diagnosis

• If the findings listed under "diagnostic features" section above are present, there really isn't much differential.
• The only mass that can mimic is a metastasis, which is exceedingly rare
  
• Occasionally a placental surface hematoma could appear this way, however it would not have the vascularity and would change/evolve on follow-up imaging