Large placental chorioangioma: a potential effective in-utero treatment modality for radio frequency ablation

Abstract

Background Placenta chorioangiomas are common benign placental tumours. While microscopic chorioangiomas are frequent, macroscopic chorioangiomas of more than 5 cm are rare and often associated with fetal complications such as high output cardiac failure, fetal anaemia and stillbirth. Close monitoring and in-utero treatment are sometimes necessary to prevent adverse pregnancy outcome. Case presentation We present two cases of large placenta chorioangiomas with one case requiring surgical therapy with radiofrequency ablation (RFA) of tumour vessels, which resulted in a successful outcome of a live birth at term. Conclusion We conclude that RFA is an effective alternative treatment modality to fetoscopic laser therapy in utero for cases at risk of fetal cardiac failure and intrauterine demise in the presence of large chorioangiomas.

Radio frequency ablation for the intrauterine treatment of giant placental chorioangioma associated with fetal compromise: A case report

“…Radiofrequency ablation is still in its infancy in the field of intrauterine fetal treatment. At present, it is mostly used for selective fetal reduction of single chorionic double amniotic twins, and it has also been reported in the treatment of chorionic hemangioma (Yulia et al, 2019). Although the operation in this case went smoothly, the patient had decompensation of fetal cardiac function before operation.…”

“…Consequently, fetal hydrops and heart failure appeared earlier, with a high possibility of poor prognosis. Yulia et al (2019) described a successful case of RFA treatment for large chorioangioma which led to a live birth at term. The treated large placenta chorioangioma measuring approximately 72 × 65 × 38 mm 3 at 24 weeks.…”

“…In utero supportive treatments such as intrauterine transfusion and amniodrainage can help with fetal anemia and polyhydramnios. Different devascularization methods have been tried but with limited success in most giant chorioangioma cases, such as fetoscopic bipolar or laser coagulation, radiofrequency ablation (RFA), cyanoacrylate embolization, anhydrous ethanol embolization, and microcoil embolization (Cheng, Yu, So, & Leung, 2017; Ercan, Coksuer, Karasahin, Alanbay, & Baser, 2012; Hosseinzadeh et al, 2015; Lau, Leung, Yu, To, & Leung, 2003; Lim et al, 2015; Voon, Amin, Kok, & Tan, 2018; Yulia et al, 2019).…”