placenta vascular lesions are a group of distinct yet related entities that include chorangiomas and diffuse multifocal chorangiomatosis. chorangioma is an expansive nodular lesion with an incidence of about 1%. diffuse multifocal chorangiomatosis is rare (0.2%) and mostly seen in placentas before the 32nd gestational week. the authors present a case of a monochorionic/biamniotic twin pregnancy, in which, at the 26th gestational week, one fetus developed intrauterine growth restriction (iugr), hydrops, and anemia associated with a tumor of the placenta with increased vascularization in the doppler study. pathological examination of the placenta diagnosed diffuse multifocal chorangiomatosis. this rare case report of diffuse multifocal chorangiomatosis with prenatal manifestations resembling those of a chorangioma proves that prenatal ultrasound detection of a placenta tumor, with increased vascularization at doppler study, must raise other diagnostic possibilities beside chorangioma.