Although most of Milagros internal organs, including her heart and lungs, were in perfect condition, she was born with serious internal defects, including a deformed left kidney and a very small right one located very low in her body. In addition, her digestive, urinary tracts and genitals shared a single tube. This birth defect occurs during the gastrulation week (week 3) of embryonic development. Gastrulation establishes the three germ layers: ectoderm, mesoderm and endoderm. It seems that complications such as defects in the urogenital system as mentioned above can be possibly due to malformations in the intermediate mesoderm. A four-hour operation to insert silicone bags between her legs to stretch the skin was successfully completed on February 8, 2005. A successful operation to separate her legs to just above the knee took place May 31, 2005, in a "Solidarity Hospital" in the district of Surquillo in Lima. The procedure, however, was so intensive that she became traumatized to the degree of losing her ability to form proper speech patterns, leaving her nearly mute. It is not known if this was a physiological or psychological condition. However, at Milagros second birthday, her mother reported that she knew more than 50 words.
It is seen protruding into the amniotic cavity near the insertion of the cord. Doppler examination shows anechoic cystic areas, with pulsatile flow in spectral analysis. Some chorioangiomas may be solid masses, and may not be identifiable in gray-scale imaging. Therefore, the investigation of choice is Colour Doppler, which also distinguishes it from placental hematoma.They can also be detected with MRI.Histologically, chorioangiomas consist of abundant vascular channels and may be cellular. Management
Expectant management is recommended for chorioangioma as majority of them are asymptomatic. Large tumors are monitored with ultrasonogram every 1–2 weeks. In case of maternal or foetal complications, possible interventions are serial foetal transfusions, fetoscopic laser coagulation of vessels supplying the tumor, endoscopic surgical devascularization and chemosclerosis using absolute alcohol. Prognosis
Large chorioangiomas with decreased echogenicity, decreased tumor volume and decreased blood flow in colour doppler images are may undergo spontaneous infarction. When chorioangiomas have deceased blood flow, fetal hemodynamics and clinical outcome are found to be improved. Epidemiology
It is the most common tumor of the placenta. Chorioangiomas over the size of 5 cm in diameter are rare, and occur at a rate of 1:3500 to 1:16,000 births. Smaller chorioangiomas are more frequent, with an incidence of 14‑139:10,000 births. However, many small chorioangiomas may not be sonologically visible and hence go unreported. In a clinical study, more than half of all tumors were discovered only by histological techniques. History
Chorioangioma was first described by Clarke in 1798. See also
Hemangioma
Chorangiosis

References
External links
Chorangioma (pathweb.uchc.edu)
Chorangioma (humpath.com)