Umbilical hemangioma: a case report

Umbilical cord tumors are extremely rare with hemangiomas and teratomas accounting for the most common tumors.

A 26-year-old woman had an anomaly scan at 22 weeks. There was an echogenic area in the umbilical cord, the mass, which appeared enlarged and oedematous findings represented an umbilical cord hemangioma, but no fetal abnormalities (Fig. 1). The second ultrasound examination for follow-up showed that the fetus was dead. The macerating fetus (46XY) weighing 650 g was autopsied, and the report confirmed umbilical cord hemangioma and no significant congenital abnormalities (Figs. 2, 3).

A high perinatal mortality and morbidity rate has been reported with hemangiomas of umbilical cord. Impaired umbilical circulation is considered as the predisposing factor for fetal demise. It is associated with premature delivery, cardiac failure, severe fetal hemorrhage, IUGR and intrauterine death. The differential diagnosis of umbilical cord hemangioma should include hematomas, varices, aneurysms, thrombosis and tumors. Close antenatal follow-up is mandatory, with serial USS examinations, which should involve AFI, tumor size and Doppler studies. The examination should be at 4 weeks intervals up to 32-34 weeks and every 1-2 weeks thereafter depending on the findings.

The prenatal diagnosis of umbilical cord hemangioma should be suspected when an echogenic mass is visualized within the umbilical cord.