Diagnostic imaging and surgical management of a congenital cervical teratoma

Abstract

Congenital cervical teratomas are rare tumours arising from the neck and consist of three major tissue layers of an embryo: the ectoderm, endoderm, and mesoderm. A great majority of cervical teratomas are benign tumours. However, the clinical significance of these tumours arises from the complications they can cause during pregnancy due to the postnatal mass effect on the airway and oesophagus of the neonate. Diagnosis of a congenital cervical teratoma is possible during an early prenatal ultrasound evaluation. The appearance depends on the size of the tumour, but it is typically a large neck mass with solid and cystic components that causes hyperextension of the neck and is frequently associated with polyhydramnios. In the postnatal period, ultrasound helps in differentiating cervical teratoma from other common congenital cervical masses. MRI is the modality of choice to evaluate the consistency of the tumour, surrounding soft tissue extent of the tumour, and any mass effect on other cervical structures. In our case report, we present a case of a full-term baby that was delivered with a large cervical mass. MRI was helpful in demonstrating the complex content of the mass, surrounding soft tissue extension, and mass effect on other major cervical structures. The clear demarcation of the mass facilitated complete surgical removal without complications.

Cervical Cystic Teratoma: An Unusual Cause of Airway Obstruction in the Pediatric Population

“…The characteristic features of cervical teratoma on ultrasound include a mass with cystic and solid components which is usually multiloculated and has multiple septa. Half of the cases show dispersed calcified areas [ 10 ]. A CT scan is also helpful in differentiating various differentials of cervical cystic teratoma.…”

“…Moreover, the MRI scan has also proven its significance as it provides valuable information regarding local invasion, anatomy, and relation to surrounding structures. All these features help a physician gather accurate information to plan a surgery [ 10 , 12 ]. In this case, we did not need an MRI, as the radiological findings of the CT scan and CT angiogram were conclusive for the establishment of diagnosis.…”

Congenital Cervical Teratoma Mimicking as Neuroblastoma on Cytology: A Diagnostic Pitfall

“…All immature teratomas having malignant foci or metastasis are considered malignant. [3] Teratomas can also occur as a part of malignant-mixed germ cell tumors wherein the malignant component is usually of germ cell origin that may be yolk sac tumor, seminoma, embryonal carcinoma, or choriocarcinoma and only rarely of somatic origin. [1] In our case, a small component of immature neuroepithelium was noted.…”

“…[2] Although usually histologically benign cervical teratomas because of their location and size can cause airway obstruction. [3] The present case report emphasizes on the rarity of cervical teratoma and difficulties faced on fine-needle aspiration cytology (FNAC) of these tumors with histopathology as a gold standard for definitive diagnosis of this entity.…”

Case report: Fetal cervical immature teratoma and copy number variations

“…Congenital cervical teratoma is a rare germ cell tumor arising from the neck ( 1 ). To our knowledge, the most common location of teratoma is the sacrococcygeal region (70%–80%), followed by the head and neck, chest, and retroperitoneum ( 2 ).…”