Fetus diagnosed with cervical teratoma delivered by exit procedure (Extra uterine intrapartum treatment)

Congenital cervical teratomas are rare tumours of germ cells that should be diagnosed antenatally by ultrasound during anomaly scan or even earlier. The incidence of teratomas of the head and neck is 3-5%. We are presenting a case of rare cervical teratoma.1 Congenital cervical tumours are often clinically dramatic, though basically benign. Prognosis is favourable only if the airway is quickly stabilized and necessarily surgical procedure is planned and executed effectively.2 Case presentation: A 34-year-old female presented at 32 weeks of gestation, at Al Amal National Hospital where an ultrasound examination revealed a single viable cephalic fetus with a huge irregular heterogeneous anterior neck mass suspected as congenital cervical neck teratoma. The delivery was planned at 37 weeks gestation. The team was assembled for EXIT procedure which includes the obstetricians, neonatologist, anthologist, ENT surgeons. At 37 weeks of gestation, the child was maintained on maternal circulation after caesarean section until successfully intubated (Extra Uterine Intrapartum Treatment (EXIT) was performed at Al Amal National Hospital after liaison with the anesthetist, neonatologist and the pediatric surgeon. A female fetus weighing 3.8 kg was delivered and intubated immediately. Unfortunately, the newborn died at 48hours of age. Conclusion: Prenatally diagnosed head and neck teratomas can result in early neonatal death if the delivery was not planned correctly with right multidisciplinary team. In this case EXIT is the procedure of choice.

Congenital cervical teratoma: about a case

Congenital cervical teratomas are benign but serious germinative cell tumors. The possibility of air compression structures and the risk of invasion of vascular and nervous noble elements are crucial prognostic factors in this kind of tumor. Prenatal diagnosis raises on ultrasound examination precising locoregional consequences of the tumor and surgical possibilities. In the propitious cases, prenatal MRI examination is useful to precise tumor’s limits and cerebral status of the foetus. At birth, coordinate management involving anaesthetists, paediatricians and specialized surgeons decrease morbidity and mortality. The recent observation of a case gave us the opportunity to make a literature review of this exceptional afection. It was a newborn female, aged 25 days allowed for anterior cervical mass evolving since the birth associated with moderate dyspnea. Cervical ultrasound coupled to CT scan had objectified a heterogeneous mass with cystic areas and calcifications. The excision was complete and the histopathological study revealed a mature teratoma. The postoperative course was uneventful, with some food and phonatory transient disorders. Cosmetic outcome at 6 months was excellent. Cervical teratoma is a rare tumor, diagnosed mainly in the neonatal period, which requires a prenatal diagnosis and multidisciplinary early management. The prognosis depends mainly on the presence of neonatal respiratory distress and histological form. There are opportunities sudden worsening respiratory and malignant transformation that justify early surgical excision and prolonged follow-up.

Teratoma of the Neck on Fine Needle Aspiration Cytology: An Unusual Case Presentation

Teratomas are tumours which are derived from all the 3 germ cell layers: endoderm, mesoderm and ectoderm with varying proportions. Cervical teratomas in children are almost always benign but locally aggressive. They can present with respiratory distress and immediate excision is required. The cervical teratoma is an uncommon entity which are rarely reported in Indian medical literature particularly on FNA. We present a case of an anterior cervical teratoma in an infant which was diagnosed on the base of FNA material.

Mature Cervical Teratoma Extending Into the Anterior Mediastinum of an Adult

There have been few reports of mature cystic teratoma, also known as a dermoid cyst, in the head and neck. Cervical neck teratoma extending into the mediastinum is also relatively rare. Here, we report a mature teratoma found in a cervical tumor in a 21-year-old man. This is the first reported case of a mature cervical teratoma extending into the anterior mediastinum. A combination of frontal X-ray, ultrasonography, computed tomography, and magnetic resonance imaging indicated a large oval heterogeneous mass surrounding the thyroid gland and trachea, underneath the sternocleidomastoid and sternohyoid, which pressed on the left lobar thyroid and trachea and extended into the anterior mediastinum. Based on preoperative observation, a diagnosis of an embryonal benign tumor was made. Although rare, this case demonstrates that these tumors should be completely removed during workup of cervical tumors.

Superior Vena Cava Syndrome and Hypoxic Ischemic Encephalopathy Secondary to a Massive, Right-Sided Immature Cervical Teratoma

Cervical teratomas are a rare form of fetal teratoma that can grow to massive size. Generally, these masses can be surgically excised after birth with excellent physical and functional prognosis because the benign variants respect anatomical borders. The primary complications of these masses are associated with compromise of the trachea and esophagus: upper airway obstruction and polyhydramnios. We report the first documented occurrence of superior vena cava syndrome and hypoxic ischemic encephalopathy associated with a massive, right-sided cervical teratoma. This case highlights that when cervical teratomas are right-sided and sufficiently large, they can extend inferiorly and compromise central venous return to the heart. This unique presentation would likely have required fetal surgical excision to avoid catastrophic cerebral injury.