NEOPLASMS OF THE UMBILICAL CORD

• Rare; 2 types (hemangioma and teratoma), both of which are benign.
• No malignant umbilical cord tumor has been described.

HEMANGIOMA

- (angiomyoma / hemangiofibromyxoma, myxosangioma, telangiectatic myxosarcoma).

• Occur near the placental end.
• It may arise from one or more umbilical vessels or from the remnants of embryonic vessels (1,2).
• Involvement of all three main vessels has been previously reported (1).
• A case of angiomatous involvement of the entire length of the cord has been reported.
• Multicystic appearance and may be impossible to differentiate from a teratoma, hematoma or umbilical cord cyst.
• Link to Ultrasound.
• Associated with stillbirth.

TERATOMA

• Solid with / without cystic areas.
• Contains tissue from all three germ cell types and occur in places where the components of the tumor are foreign to surrounding tissue.

ANGIOMYXOMA

Rare tumors, that are usually benign but may be associated with fetal death. They present as solid heterogeneous masses.

Large masses of mucus in the umbilical cord are usually associated with hemangiomas of the umbilical cord, also called angiomyxomas. The large pseudocysts are probably fluid collections produced by this tumor. The fluid cannot escape through the thick epithelium of the umbilical cord and appears as a large cystic mass (1).

Bergman 1962 (5); 2 cases - one stillborn and one alive and normal.
Iaccarino 1986 (6); 7cm cyst compressing the umbilical vessels and IUGR.

REFERENCES

1. Heifetz SA, Rueda-Pedraza ME. Hemangiomas of the umbilical cord. Pediatr Pathol 1983;1:385.
2. Jauniaux E, Moscoso G, Chitty L et.al. An angiomyxoma involving the whole length of the umbilical cord. Prenatal diagnosis by ultrasonography. J Ultrasound Med 1990;9:419-422.
3. Seifer DB, Ferguson JE, Behrens CM et.al. Non-immune hydrops fetalis in association with hemangioma of the umbilical cord. Obstet Gynecol 1985;66:283.
4. Mishriki YY, Vanyshelbaum Y, Epstein H et.al. Hemangioma of the umbilical cord. Pediatr Pathol 1987;7:43.
5. Bergman P, Lundin P, Malmstrom T. Mucoid degeneration of Wharton's jelly: An umbilical cord anomaly threatening fetal life. Acta Obstet Gynecol Scand 1961;40:372.
6. Iaccarino M, Baldi F, Persico O et.al. Ultrasonographic and pathologic study of mucoid degeneration of the umbilical cord. J Clin Ultrasound 1986;15:127.