Korean J Obstet Gynecol.  2012 Jan;55(1):33-37. 10.5468/KJOG.2012.55.1.33.

Fetomaternal hemorrhage caused by an intraplacental choriocarcinoma

• Jeong JE
• Moon SH
• Park KH
• Shin N
• Lee CH
• Kim SC

• KMID: 1836761
• DOI: http://doi.org/10.5468/KJOG.2012.55.1.33

Abstract

Intraplacental choriocarcinoma is rare, and occasionally results in massive feto-maternal hemorrhage. We describe a case of an intraplacental choriocarcinoma diagnosed postpartum after a preterm cesarean delivery of a severely anemic newborn. The microscopic examination showed that clusters of malignant trophoblasts arose from residual normal chorionic villi and infiltrated into the intervillous spaces, confirmed as intraplacental choriocarcinoma. Fetomaternal hemorrhage is a rare complication of choriocarcinoma but its presence should always warrant detailed examination of placenta, mother, and infant.

Keyword

Fetomaternal hemorrhage; Fetal distress; Intraplacental choriocarcinoma

MeSH Terms

Choriocarcinoma
Chorionic Villi
Female
Fetal Distress
Fetomaternal Transfusion
Hemorrhage
Humans
Infant
Infant, Newborn
Mothers
Placenta
Postpartum Period
Pregnancy
Trophoblasts

Figure

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  Fig. 1 Cardiotocographic monitoring before delivery shows repetitive late decelerations and decreased variability.

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  Fig. 2 The cut surface of placental disk is pale but not hydroptic. Under the cord insertion site, an ill-defined brown to gray lesion is present (white arrow) and the background area is hemorrhagic.

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  Fig. 3 There were several histologic findings that can be suggested feto-materal hemorrhage; segmental infarct (arrow, A) and intervillus hemorrhage (arrowhead, A) and increased number of nucleated RBCs (white arrow, B) within a focus of intervillus hemorrhage (B) (H&E; ×100, ×200).

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  Fig. 4 Solid nests of partially anaplastic tumor cells surrounding the residual villi are in the typical pattern of intraplacental choriocarcinoma (H&E, ×100).

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