Case of the Week #556

* Frantisek Grochal; ** Haslik Lubomir
* Femicare, Center of prenatal ultrasonographic diagnostics, Kollarova 17/A, 036 01 Martin, Slovak Republic; ** The Institute for Mother and Child Care in Prague - Podolí, Czech Republic

Posting Dates: April 1 - April 14, 2022

A 24-year-old secundigravida, primipara presented to our office at 24 weeks and 6 days of her pregnancy due to a right-sided cranial parieto-occipital mass of the fetus.

Here are the images and videos that we obtained:

Image 1 © 2021 Grochal
Image 2 © 2021 Grochal
Image 3 © 2021 Grochal
Image 4 © 2021 Grochal
Image 5 © 2021 Grochal
Image 6 © 2021 Grochal
Image 7 © 2021 Grochal
Image 8 © 2021 Grochal
Image 9 © 2021 Grochal
Image 10 © 2021 Grochal
Image 11 © 2021 Grochal
Video 1 © 2021 Grochal
Video 2 © 2021 Grochal
Video 3 © 2021 Grochal
Video 4 © 2021 Grochal

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Answer

A 24-year-old secundigravida, primipara presented to our office at 24 weeks and 6 days of her pregnancy due to a right-sided cranial parieto-occipital mass of the fetus.

At 24w+6d a highly vascularized, mostly solid mass of size 58 x 45 x 34 was found in right-parieto-occipital subcutaneous region. Vascular supply of the lesion could be traced to the right vertebral artery.

Series of exams were done later in pregnancy and the size of the lesion had stayed approximately the same with overall mass volume about 58 cm3.

Our presumed diagnosis was hemangioma-hemangioendothelioma.

The mother was sent to The Institute for Mother and Child Care in Prague - Podolí, Czech Republic, for consultation and further management. A eutrophic male newborn was delivered via cesarean section at 38 weeks and 3 days due to non-progressive labor.

Diagnosis of hemangioma-hemangioendothelioma was clinically confirmed after delivery. The baby was placed on Propranolol treatment. At the time of posting this case, the baby is fourth-month old and is doing well. The size of the tumorous mass diminishes gradually, and so no surgical treatment was recommended so far.

Image 1 © 2021 Grochal
Image 2 © 2021 Grochal

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