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Intraplacental Leiomyoma in a Case of Second-Trimester Intrauterine Fetal Demise.
Clin Pathol. 2020 Jan-Dec; 13:2632010X20928328.CP

Abstract

Intraplacental leiomyomas are extremely rare and are generally incidental findings in term placentas. We present the first reported case of a placental leiomyoma associated with preterm intrauterine fetal demise, with histological findings providing the cause of adverse outcome. This was an intrauterine fetal demise detected at 26 weeks gestation with a placental finding of a 2.8-cm leiomyoma. Histological findings in the placenta and fetus were consistent with intrauterine fetal demise of weeks. The umbilical cord was markedly hypercoiled, with 6 twists per 10 cm. Features of maternal vascular malperfusion were evident in the placenta, including villous hypermaturity, an infarct adjacent to the leiomyoma, and retention of smooth muscle in spiral arterioles within the decidua overlying the leiomyoma. Implantation-site trophoblasts invaded into the leiomyoma and the overlying decidua. We hypothesize that incorporation of the leiomyoma into the placenta contributed to fetal demise due to disordered placental implantation, implying that these tumors may not be as benign and incidental as previously described. The finding of implantation-site changes in the leiomyoma may also suggest a potential cause for this rare tumor.

Authors+Show Affiliations

Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH, USA. Department of Pathology, The Ohio State University, Columbus, OH, USA.Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH, USA. Department of Pathology, The Ohio State University, Columbus, OH, USA.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

32596665

Citation

Koo, Selene C., and Fang Bu. "Intraplacental Leiomyoma in a Case of Second-Trimester Intrauterine Fetal Demise." Clinical Pathology (Thousand Oaks, Ventura County, Calif.), vol. 13, 2020, p. 2632010X20928328.
Koo SC, Bu F. Intraplacental Leiomyoma in a Case of Second-Trimester Intrauterine Fetal Demise. Clin Pathol. 2020;13:2632010X20928328.
Koo, S. C., & Bu, F. (2020). Intraplacental Leiomyoma in a Case of Second-Trimester Intrauterine Fetal Demise. Clinical Pathology (Thousand Oaks, Ventura County, Calif.), 13, 2632010X20928328. https://doi.org/10.1177/2632010X20928328
Koo SC, Bu F. Intraplacental Leiomyoma in a Case of Second-Trimester Intrauterine Fetal Demise. Clin Pathol. 2020 Jan-Dec;13:2632010X20928328. PubMed PMID: 32596665.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intraplacental Leiomyoma in a Case of Second-Trimester Intrauterine Fetal Demise. AU - Koo,Selene C, AU - Bu,Fang, Y1 - 2020/06/15/ PY - 2020/04/16/received PY - 2020/04/30/accepted PY - 2020/6/30/entrez KW - Placenta KW - fetal demise KW - leiomyoma KW - myometrium KW - perinatal KW - placental implantation SP - 2632010X20928328 EP - 2632010X20928328 JF - Clinical pathology (Thousand Oaks, Ventura County, Calif.) JO - Clin Pathol VL - 13 N2 - Intraplacental leiomyomas are extremely rare and are generally incidental findings in term placentas. We present the first reported case of a placental leiomyoma associated with preterm intrauterine fetal demise, with histological findings providing the cause of adverse outcome. This was an intrauterine fetal demise detected at 26 weeks gestation with a placental finding of a 2.8-cm leiomyoma. Histological findings in the placenta and fetus were consistent with intrauterine fetal demise of weeks. The umbilical cord was markedly hypercoiled, with 6 twists per 10 cm. Features of maternal vascular malperfusion were evident in the placenta, including villous hypermaturity, an infarct adjacent to the leiomyoma, and retention of smooth muscle in spiral arterioles within the decidua overlying the leiomyoma. Implantation-site trophoblasts invaded into the leiomyoma and the overlying decidua. We hypothesize that incorporation of the leiomyoma into the placenta contributed to fetal demise due to disordered placental implantation, implying that these tumors may not be as benign and incidental as previously described. The finding of implantation-site changes in the leiomyoma may also suggest a potential cause for this rare tumor. SN - 2632-010X UR - https://www.unboundmedicine.com/medline/citation/32596665/Intraplacental_Leiomyoma_in_a_Case_of_Second-Trimester_Intrauterine_Fetal_Demise L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/32596665/ DB - PRIME DP - Unbound Medicine ER -
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