PERINATAL MANAGEMENT OF A LINGUAL TERATOMA

• Published in: Obstetrics and gynecology (New York. 1953) Vol. 87; no. 5, Part 2 Suppl; pp. 848 - 851
• Main Authors: McMahon, Michael J, Chescheir, Nancy C, Kuller, Jeffrey A, Wells, Steven R, Wright, Lydia N, Nakayama, Don K
• Format: Journal Article
• Language: English
• Published: New York, NY The American College of Obstetricians and Gynecologists 01.05.1996; Elsevier Science
• Subjects: Adult; Biological and medical sciences; Female; Fetal Diseases - diagnostic imaging; Humans; Infant, Newborn; Male; Medical sciences; Otorhinolaryngology. Stomatology; Pharyngeal Neoplasms - congenital; Pharyngeal Neoplasms - diagnostic imaging; Pharyngeal Neoplasms - surgery; Pregnancy; Teratoma - congenital; Teratoma - diagnostic imaging; Teratoma - surgery; Tongue Neoplasms - congenital; Tongue Neoplasms - diagnostic imaging; Tongue Neoplasms - surgery; Tumors; Ultrasonography, Prenatal; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology; Human; Case study; Newborn diseases; Tongue; Teratoma; Clinical management; Newborn; Perinatal; ENT disease; Tumor
• ISSN: 0029-7844; 1873-233X

BACKGROUNDTeratomas of the head and neck are and occur almost exclusively in neonates. Prenatal diagnosis of these tumors allows for a carefully planned delivery that maintains an open airway and potentially imporves perinatal outcome. We report the perinatal management of a huge intrapharyngeal and intra-oral teratoma that had a broad connection to the base of the tongue. CASEAn anterior neck mass (5x5 cm) in an otherwise normal-appearing fetus was detected at 19 weeksʼ gestatin. The mass increased in size over the next 10 weeks to 8 X 6.8 X 4.3 cm. Marked fetal head deflexion ws noted along wiht concomitant hydramnios. The mother had spontaneous repture of membrances with preterm labor at 29 weeksʼ gestation. A 1860-g male neonate was delivered by classical cesarean delivery. A tracheostomy was performed in the delivery room for ventilation after the upper aiway could not be accessed by bronchoscopy. Histology examination after surgical excision confirmed a congenital teratoma with immature neuroectodemal tissue and alpha-fetoproteinbgeaing endodermal sinus tumor components with exclusively polyvesicular vitelline charcteristics. The origin of the pharynegel mass was the base of the tongue. CONCLUSIONThe prenatal diagnosis of a pharyngeal teratoma should prompt a careful delivery plan to optimize perinatal outcome.