Introduction/Objective Chorangioma is a benign vascular tumor of the placenta, likely hamartoma, occurring in 1% of all examined placentas and arising from the primitive chorionic mesenchyme. The clinical significance is related to the size of the tumor. Most chorangiomas are small and asymptomatic; however, those larger than 4 cm are associated with intrauterine growth restriction (IUGR), polyhydramnios, preterm delivery, arteriovenous shunting, hydrops, and fetal thrombocytopenia. Methods/Case Report Herein, we present a case report of a placenta with two chorangiomas that are prenatally detected in a 25-year-old G2P1 female patient by ultrasound which showed a placental mass and mild polyhydramnios. The patient also developed hypertension and preeclampsia so she was referred for early induction of labor. The patient was elected for caesarian section and the placenta was delivered at 35 weeks of gestation. Grossly, two tan soft well-circumscribed lobulated placental masses were identified and measured 9.5 x 9.1 x 3.3 cm and 5.5 x 4.5 x 1.9 cm, respectively. The two masses were joined together by a thick blood vessel. The larger 9.5 cm mass was connected to the placental disc at the umbilical cord insertion site and is associated with blood vessel thrombosis. Microscopically the mass showed proliferation of capillary-sized vessels with surrounding stroma consistent with chorangioma. Clinical, radiological, and microscopic profiles support the diagnosis of placental chorangioma. Results (if a Case Study enter NA) N/A Conclusion To our knowledge, this is the first case report of two giant placental chorangiomas connected together by a thick blood vessel. Although both are giant (more than 4 cm), early diagnosis and timely intervention led to good maternal and neonatal outcomes aided with neonatal intensive care unit management.
Introduction/Objective Giant cell myocarditis (GCM) is a rare and aggressive inflammatory process that targets the myocardium and is often rapidly fatal. Most cases have been reported in young to middle aged adults with a slight male predominance. The etiology of this disease is largely unknown, however there is an association with multiple autoimmune disorders. Most patients present with rapidly progressive or fulminant heart failure, arrhythmias, heart block or sudden cardiac death. The incidence of GCM ranges from 0.007% to 0.051% and most cases are confirmed on autopsy examination. Here we present a case of GCM in a young female diagnosed on autopsy. Methods/Case Report A 37-year-old female presented with shortness of breath and chest pain for a 5-day duration. She had no past medical history and was otherwise well before the onset of symptoms. On admission, she was noted to have clinical findings consistent with heart failure and progressed to cardiogenic shock with ventricular arrhythmias within hours. Despite high dose corticosteroids and other supportive therapy, the patient remained in refractory, vasodilatory shock, in cardiac standstill and eventually died. Findings on autopsy included mild ventricular hypertrophy, petechial hemorrhages through out the atria and ventricles, as well as pulmonary edema and congestion. Microscopic examination showed a diffuse infiltrating pattern of inflammation within the heart, that was composed predominantly of lymphocytes, giant cells, scattered neutrophils, and eosinophils. The lymphocytes were CD3, CD4, CD8 positive and CD20 negative, consistent with a T-cell infiltrate. Gram and GMS stains were negative for bacterial and fungal microorganisms. Focal areas of necrosis without granuloma formation are also noted ruling out sarcoidosis. Results (if a Case Study enter NA) NA. Conclusion This case demonstrates a rapid manifestation of GCM in a previously healthy individual. GCM must be considered in the differential diagnosis when a young patient presents with cardiac symptoms. Early diagnosis and initiation of targeted therapy is critical for GCM patients' survival.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.