Chorangiocarcinoma of the placenta: a case report and clinical review.
OBJECTIVE
We describe a case of chorangiocarcinoma, a complex lesion consisting of a trophoblastic proliferation within a chorangioma, presenting in a term placenta.


METHODS
The lesion was diagnosed by ultrasound at a second trimester check-up after amniocentesis, performed because of increased combined risk at first trimester screening for trisomy 21. After uncomplicated vaginal delivery, a healthy child was born and the placenta was expelled spontaneously.


RESULTS
Gross examination of the placenta showed a well-demarcated mass, bulging paracentrally from the fetal surface. Histology revealed a trophoblastic proliferation inside a chorangioma, consisting of multiple nodules with characters of focal multinucleation and pleomorphic cell nuclei, extensive central necrosis and high mitotic activity. Immunohistochemical staining showed strong intensity for hCG; Ki-67 (MIB-1) demonstrated a high proliferation index. Histopathological and immunohistochemical profile was compatible with a malignant trophoblastic proliferation.


CONCLUSIONS
This is only the fifth reported case of so-called "chorangiocarcinoma" of the placenta (Table 1). However, histopathologically only one reported case was identical to ours. A proliferation of atypical trophoblast was observed inside a chorangioma, which formed as it were a shield around the trophoblast. No extravascular stromal invasion was present. Follow-up revealed no metastases, either in the mother or the child, up to 3 months after birth.
Department of Gynaecology-Obstetrics, AZ Turnhout, Belgium. Tine.faes@azturnhout.be
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T
Faes
A
A
Pecceu
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S
Van Calenbergh
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P
Moerman
D000328:Adult; D005260:Female; D006391:Hemangioma / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D010920:Placenta / Q000000981:diagnostic imaging / Q000473:pathology*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000000981:diagnostic imaging* / Q000473:pathology; D047929:Term Birth; D018245:Trophoblastic Tumor, Placental Site / Q000000981:diagnostic imaging* / Q000473:pathology; D016216:Ultrasonography, Prenatal; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology