TITLE:
Giant Placental Chorioangioma with Favourable Outcome
AUTHORS:
Shamsa Alnoor Kassam, Siddesh Prabhulingam, Samantha Josephine Haidzi, Shyam Das
KEYWORDS:
Placental Chorioangioma, Giant Placental Chorioangioma, Polyhydramnios, Fetal Hydrops, Placental Infarction
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.16 No.9,
September
23,
2026
ABSTRACT: Introduction: Chorioangioma is the most common benign tumour of the placenta. Small chorioangiomas are usually asymptomatic, whereas giant chorioangiomas (>4 cm) are rare and may be associated with significant maternal and fetal complications, including polyhydramnios, fetal hydrops, cardiomegaly, fetal anaemia, congestive cardiac failure, intrauterine death, antepartum haemorrhage and preterm delivery. These complications may result from arteriovenous shunting through the tumour. We present a rare case of a giant placental chorioangioma associated with severe polyhydramnios but a favourable perinatal outcome following conservative management. Case Report: A 28-year-old para 3 woman was diagnosed with a giant placental chorioangioma at 21 + 3 weeks of gestation. The tumour measured 27 × 24 × 43 mm and was located at the placental edge. Despite progressive growth, reaching 94 × 37 × 63 mm at 33 + 5 weeks, the patient remained asymptomatic, with normal fetal growth and normal umbilical artery Doppler studies. Severe polyhydramnios subsequently developed, with an amniotic fluid index (AFI) of 36 cm, necessitating hospital admission for close maternal and fetal surveillance and administration of antenatal corticosteroids in anticipation of possible preterm delivery should the maternal or fetal condition deteriorate. The case was discussed regularly at the multidisciplinary team (MDT) meeting, and the plan was for delivery at 37 weeks provided maternal and fetal conditions remained stable. The patient subsequently had an uncomplicated vaginal delivery at 37 + 2 weeks. The neonate weighed 2792 g and was clinically well. The placenta weighed 1926 g, with the chorioangioma measuring 10 × 5 cm. Histological examination confirmed a chorioangioma with areas of infarction and calcification. Discussion: Chorioangioma is a rare placental tumour that can be associated with significant maternal and fetal complications, particularly when the lesion exceeds 4 cm in diameter. Polyhydramnios is one of the most commonly reported complications of giant chorioangiomas and may result from increased transudation of fluid across the tumour or impaired fetal swallowing secondary to polyhydramnios-related complications. Diagnosis and monitoring rely primarily on ultrasound assessment, including serial evaluation of tumour size, fetal growth, amniotic fluid volume and Doppler studies. In uncomplicated cases, conservative management with close ultrasound surveillance may be appropriate. Severe cases with evidence of fetal compromise may require interventions such as laser coagulation of feeding vessels, embolization, alcohol injection or therapeutic amnio drainage. However, invasive procedures carry significant risks, including fetal bleeding, exsanguination and fetal death, and therefore require careful multidisciplinary consideration. In this case, the absence of evidence of fetal anaemia, hydrops or hyperdynamic circulation allowed conservative management despite the substantial size of the tumour, resulting in a favourable maternal and neonatal outcome. Conclusion: Giant placental chorioangiomas are rare and can be associated with serious maternal and fetal complications. Close surveillance with serial ultrasound assessment, fetal Doppler studies and multidisciplinary management is essential. In the absence of fetal compromise, conservative management may be appropriate, even in the presence of significant tumour growth and polyhydramnios. This case highlights the importance of individualized management, careful counselling and timely intervention to achieve a favourable outcome.