Course and outcome of a pregnancy with a giant fetal cervical teratoma diagnosed prenatally

Axt-Fliedner, R; Hendrik, Hans-Joachim; Ertan, Kubilay; Remberger, K.; Schmidt, Werner

doi:10.1046/j.0960-7692.2001.00461.x

Cited by 24 publications

(21 citation statements)

References 22 publications

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“…Plain X-rays and ultrasonography reveal solid and cystic structures within a heterogeneous mass with calcifications in up to 50% of cases [17][18][19][20][21][22][23][24]. The extent of vascularization can be assessed by Doppler flow imaging [25]. CT scans of the head, neck, and chest can provide more complete information regarding invasion and anatomical extension of tumor and may allow accurate reconstruction of the anatomy [26].…”

Section: Discussionmentioning

confidence: 98%

Teratomas of the neck and mediastinum in children

et al. 2006

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This retrospective study reviews a series of teratomas of the neck and mediastinum aiming at defining the features of these particular locations. We recorded prenatal diagnosis, perinatal management, clinical and radiologic features, pathology, surgical strategies and results in cervical and mediastinal teratomas treated over the last 10 years. During this period we treated 66 children with teratoma of which 11 (6 male and 5 female) had cervicomediastinal locations. Five babies had cervical teratomas extended into the anterior mediastinum in two cases. Prenatal diagnosis was made in three (two with polyhydramnios). Four babies were born by C-section and only one had a successful EXIT procedure. The diagnosis was confirmed by imaging and increased AFP. Surgical treatment involved total tumor removal and in one case subsequent removal of lymph node metastases. All children survived except one in whom airway could not be cleared at birth. Two children bear mild hypothyroidism. During the same period six patients aged 0-17 years were treated for mediastinal teratoma. Only one was prenatally diagnosed and only two had some dyspnea. Removal was performed either by median sternotomy, thoracotomy, or thoracoscopy. They all survive and are free of disease. Teratomas of the neck may cause fetal disease and unmanageable neonatal airway obstruction. Prenatal diagnosis and planned multidisciplinary management are mandatory at birth. In contrast, only some mediastinal tumors cause respiratory embarrassment. Although benign, these tumors are sometimes immature and may metastasize to regional lymph nodes. Total surgical removal is curative. Thyroid insufficiency may be present at birth in cervical teratomas and may be aggravated by surgery.

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Section: Discussionmentioning

confidence: 98%

Teratomas of the neck and mediastinum in children

et al. 2006

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“…Calcifications may be seen within the mass in up to 50% of cases [4]. Rapid enlargement can be seen related to the cystic components [5].…”

Section: Discussionmentioning

confidence: 95%

“…As a result of rapid growth and expansion of a cervical teratoma, the tumor may deviate and totally occlude the trachea and esophagus, resulting in polyhydramnios due to impairment of fetal swallowing [2,3]. Polyhydramnios can be severe, requiring therapeutic amniocentesis, sometimes on multiple occasions [3,4,8]. These tumors are also known to cause fetal hydrops; the mechanism of fetal hydrops is postulated to be caused by arteriovenous shunting within the massive tumor, which leads to high output heart failure [4,9].…”

Section: Discussionmentioning

confidence: 98%

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Successful prenatal and perinatal management of a massive cervicofacial teratoma

et al. 2011

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We report a fetus with a massive cervicofacial teratoma successfully managed in the prenatal and perinatal period. A 34-year-old woman was referred to our hospital at 16 weeks' gestation. Ultrasound examination revealed a left anterolateral fetal neck mass indicating typical findings of a teratoma. The tumor grew to tremendous size until occupying most of the uterine cavity causing severe discomfort for the patient. This necessitated ultrasound-guided removal of the intracystic fluid of the massive cervicofacial teratoma during pregnancy. Fetal MRI clearly demonstrated the mass extending from the orbit to the anterior chest wall without compression or deviation of the fetal airway. The entire mass increased to 18 cm in diameter at 37 weeks' gestation. Classical cesarean section was performed immediately after ultrasound-guided removal of the fluid from the cyst. A female infant weighing 3562 g was delivered. Resection of the tumor was accomplished on day 28 of life. The successful outcome in our case illustrates the value of accurate prenatal diagnosis of a giant cervicofacial teratoma using ultrasound and MRI, and careful management of the mother and fetus during the prenatal and perinatal period. It seems that ultrasound-guided removal of the intracystic fluid from the tumor during pregnancy should be considered to prevent preterm delivery.

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“…1,[3][4][5][6][7][8] In certain cases (ie, giant melanocytic nevus with hamartoma), 6 the 3D multiplanar images were not as useful as initially expected. Those authors reported that it was hard to gain further information from the multiplanar images because of the absence of landmarks.…”

Section: Discussionmentioning

confidence: 99%