ULTRASOUND OF UMBILICAL CORD HEMANGIOMA

• Angiomatous nodule ranging in size from 0.2 - 17cm (1).
• Nodule is surrounded by edema of Wharton's jelly. The cord edema may extend for a variable distance along the cord (up to 42cm) (1).
• More frequent towards the placental end.
• Nodule is surrounded or intimately associated with one or more of the main umbilical vessels indicating origin from these structures (1). Involvement of all three vessels has been reported once (2).
• May less commonly arises from the fetal end of the cord and may arise from the vitelline capillaries (1,3).
• Nodule is hyperechoic.
• In contrast to placental hemangiomas, polyhydramnios is not usually present.
• An umbilical cord pseudocyst is due to myxomatous degeneration of Wharton's jelly is often associated.

DIFFERENTIAL DIAGNOSIS

• Teratoma.
• Cord hematoma (usually hypoechoic and septated unless acute when it may be echogenic).

REFERENCES

1. Ghidini A, Romero R, Eisen RN et.al. Umbilical cord hemangioma. J Ultrasound Med 1990;9:297-300.
2. Heifetz SA, Rueda-Pedraya ME. Hemangiomas of the umbilical cord. Pediatr Pathol 1983;1:385.
3. Dombrowski MP, Budev H, Wolfe HM et.al. Fetal hemorrhage from umbilical cord hemangioma. Obstet Gynecol 1987;70:439.