Abstract
Histological lesions involving the intervillous space include inflammatory and infectious diseases covered elsewhere, maternal malignancies, maternal haematological disease and trophoblastic lesions including choriocarcinoma. Placental involvement by maternal malignancies is uncommon, but likely under-reported as the lesions often are not visible on macroscopic examination, and may mimic infarcts or other benign lesions such as perivillous fibrin with intermediate trophoblast. Mostly they arise from haematogenous spread, but direct tumour extension is also reported. Malignant melanoma is the most common tumour to spread, followed by lung and breast cancer and leukaemia/lymphoma. Maternal metastasis involves the intervillous space and, in a small proportion of cases, chorionic villous invasion with or without vascular invasion is also present. Fetal/infant metastasis is rare. Malignant tumour cell spread to the conceptus has to be compared to the increasing recognition of the role of two-way benign cell transfer causing microchimerism of the mother and fetus in both maternal and childhood diseases. A number of cases with placental metastases appear associated with stillbirth due to many possible causes but only rarely due to fetal metastases.
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References
Al-Adnani M, Kiho L, Scheimberg I. Maternal pancreatic carcinoma metastatic to the placenta: a case report and literature review. Pediatr Dev Pathol. 2007;10:61–5.
van der Velden VH, Willemse MJ, Mulder MF, Szczepański T, Langerak AW, Wijkhuijs JM, et al. Clearance of maternal leukaemic cells in a neonate. Br J Haematol. 2001;114:104–6.
Broestl L, Rubin JB, Dahiya S. Fetal microchimerism in human brain tumors. Brain Pathol. 2017; https://doi.org/10.1111/bpa.12557.
Gammill HS, Harrington WE. Microchimerism: defining and redefining the prepregnancy context—a review. Placenta. 2017; https://doi.org/10.1016/j.placenta.2017.08.071.
Kinder JM, Stelzer IA, Arck PC, Way SS. Immunological implications of pregnancy-induced microchimerism. Nat Rev Immunol. 2017;17:483–94.
Altman JF, Lowe L, Redman B, Esper P, Schwartz JL, Johnson TM, et al. Placental metastasis of maternal melanoma. J Am Acad Dermatol. 2003;49:1150–4.
Baergen RN, Johnson D, Moore T, Benirschke K. Maternal melanoma metastatic to the placenta: a case report and review of the literature. Arch Pathol Lab Med. 1997;121:508–11.
Alexander A, Samlowski WE, Grossman D, Bruggers CS, Harris RM, Zone JJ, et al. Metastatic melanoma in pregnancy: risk of transplacental metastases in the infant. J Clin Oncol. 2003;21:2179–86.
Pavlidis N, Pentheroudakis G. Metastatic involvement of placenta and fetus in pregnant women with cancer. Recent Results Cancer Res. 2008;178:183–94.
Voulgaris E, Pentheroudakis G, Pavlidis N. Cancer and pregnancy. A comprehensive review. Surg Oncol. 2011;20:e175–85.
De Carolis S, Garofalo S, Degennaro VA, Zannoni GF, Salvi S, Moresi S, et al. Placental and infant metastasis of maternal melanoma: a new case. J Obstet Gynaecol. 2015;35:417–8.
Menada MV, Moioli M, Garaventa A, Nozza P, Foppiano M, Trimarchi N, et al. Spontaneous regression of transplacental metastases from maternal melanoma in a newborn: case report and review of the literature. Melanoma Res. 2010;20:443–9.
Brossard J, Abish S, Bernstein ML, Baruchel S, Kovacs L, Pollack R. Maternal malignancy involving the products of conception: a report of malignant melanoma and medulloblastoma. Am J Pediatr Hematol Oncol. 1994;16:380–3.
Ackerman J, Gilbert-Barness E. Malignancy metastatic to the products of conception: a case report with literature review. Pediatr Pathol Lab Med. 1997;17:577–86.
Boussios S, Han SN, Fruscio R, Halaska MJ, Ottevanger PB, Peccatori FA, et al. Lung cancer: report of nine cases from an international collaborative study. Lung Cancer. 2013;82:499–505.
Jackisch C, Louwen F, Schwenkhagen A, Karbowski B, Schmid KW, Schneider HP, et al. Lung cancer during pregnancy involving the products of conception and a review of the literature. Arch Gynecol Obstet. 2003;268:69–77.
Azim HA Jr, Peccatori FA, Pavlidis N. Lung cancer in the pregnant woman: to treat or not to treat, that is the question. Lung Cancer. 2010;67:251–6.
Tolar J, Coad JE, Neglia JP. Transplacental transfer of small-cell carcinoma of the lung. N Engl J Med. 2002;346:1501–2.
Folk JJ, Curioca J, Nosovitch JT Jr, Silverman RK. Poorly differentiated large cell adenocarcinoma of the lung metastatic to the placenta: a case report. J Reprod Med. 2004;49:395–7.
Sheikh SS, Khalifa MA, Marley EF, Bagg A, Lage JM. Acute monocytic leukemia (FAB M5) involving the placenta associated with delivery of a healthy infant: case report and discussion. Int J Gynecol Pathol. 1996;15:363–6.
Horowitz NA, Benyamini N, Wohlfart K, Brenner B, Avivi I. Reproductive organ involvement in non-Hodgkin lymphoma during pregnancy: a systematic review. Lancet Oncol. 2013;14:e275–82.
Maruko K, Maeda T, Kamitomo M, Hatae M, Sueyoshi K. Transplacental transmission of maternal B-cell lymphoma. Am J Obstet Gynecol. 2004;191:380–1.
Meguerian-Bedoyan Z, Lamant L, Hopfner C, Pulford K, Chittal S, Delsol G. Anaplastic large cell lymphoma of maternal origin involving the placenta: case report and literature survey. Am J Surg Pathol. 1997;21:1236–41.
Pollack RN, Sklarin NT, Rao S, Divon MY. Metastatic placental lymphoma associated with maternal human immunodeficiency virus infection. Obstet Gynecol. 1993;81:856–7.
Kurtin PJ, Gaffey TA, Habermann TM. Peripheral T-cell lymphoma involving the placenta. Cancer. 1992;70:2963–8.
Herskovic E, Ryan M, Weinstein J, Wadhwani NR. Maternal to fetal transmission of cervical carcinoma. Pediatr Radiol. 2014;44:1035–8.
Momeni M, Cantu J, Young AE. Placental abruption and fetal demise secondary to placental metastases from unknown primary: a case report. J Reprod Med. 2013;58:341–3.
Pavlidis N, Peccatori FA, Lofts F, Greco AF. Cancer of unknown primary during pregnancy: an exceptionally rare coexistence. Anticancer Res. 2015;35:575–9.
Dessolle L, Dalmon C, Roche B, Daraï E. Placental metastases from maternal malignancies: review of the literature. J Gynecol Obstet Biol Reprod (Paris). 2007;36:344–53.
Dessolle L, Dalmon C, Roche B, Menain N, Daraï E. Placental metastases from a maternal squamous cell tumor of the maxillary. Eur J Obstet Gynecol Reprod Biol. 2005;123:117–8.
Jeong B, Shim JY, Kim CJ, Won HS, Lee PR, Kim A. Massive perivillous fibrin deposition in the placenta and uterine metastasis of gastric adenocarcinoma during pregnancy. J Obstet Gynaecol Res. 2014;40:1150–3.
Aker S, Katlan DC, Yüce T, Söylemez F. Placental hepatic, and supraclavicular lymph node metastasis in pancreatic adenocarcinoma during pregnancy: a case report. Turk J Obstet Gynecol. 2016;13:161–3.
Heller DS, Hatem F. Endometrial stromal neoplasm in the placenta: report of a case and review of the literature. Int J Gynecol Pathol. 2018;37:32–4.
Sakurai H, Mitsuhashi N, Ibuki Y, Joshita T, Fukusato T, Niibe H. Placental metastasis from maternal primitive neuroectodermal tumor. Am J Clin Oncol. 1998;21:39–41.
Kishkurno S, Ishida A, Takahashi Y, Arai H, Nakajima W, Abe T, Takada G. A case of neonatal choriocarcinoma. Am J Perinatol. 1997;14:79–82.
Picton SV, Bose-Haider B, Lendon M, Hancock BW, Campbell RH. Simultaneous choriocarcinoma in mother and newborn infant. Med Pediatr Oncol. 1995;25:475–8.
Bloomfield RD, Suarez JR, Malangit AC. The placenta: a diagnostic tool in sickle cell disorders. J Natl Med Assoc. 1978;70:87–8.
Trampont P, Roudier M, Andrea AM, Nomal N, Mignot TM, Leborgne-Samuel Y, Ravion S, Clayton J, Mary D, Elion J, Decastel M. The placental-umbilical unit in sickle cell disease pregnancy: a model for studying in vivo functional adjustments to hypoxia in humans. Hum Pathol. 2004;35:1353–9.
Weibull CE, Eloranta S, Smedby KE, Björkholm M, Kristinsson SY, Johansson AL, Dickman PW, Glimelius I. Pregnancy and the risk of relapse in patients diagnosed with Hodgkin lymphoma. J Clin Oncol. 2016;34:337–44.
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Charles, A.K., Bründler, MA. (2019). Intervillous Space: Infiltrates. In: Khong, T., Mooney, E., Nikkels, P., Morgan, T., Gordijn, S. (eds) Pathology of the Placenta. Springer, Cham. https://doi.org/10.1007/978-3-319-97214-5_31
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