Fetal mediastinal teratoma: Misinterpretation as congenital cystic lesions of the lung on prenatal ultrasound

Darouich, Sihem; Bellamine, Houda

doi:10.1002/jcu.22808

Cited by 10 publications

(17 citation statements)

References 14 publications

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“…Prenatal US diagnosis of mediastinal teratoma has been scarcely reported, especially in the second trimester, and is summarized in Table 1 [2,[7][8][9]13,14,[18][19][20][21][22][23][24]. In our case, a mediastinal mass was detected at US at 21 wga + 1 day, being the second fetal case reported both with an early diagnosis and without hydrops.…”

Section: Discussionmentioning

confidence: 90%

“…Prenatal US diagnosis of mediastinal teratoma has been scarcely reported, especially in the second trimester, and is summarized in Table 1 [ 2 , 7 , 8 , 9 , 13 , 14 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…In our case, histopathological examination revealed an immature teratoma, Norris grade 2. The immature type seems the most common in the prenatal setting [ 2 , 4 , 7 , 13 , 14 , 18 , 19 ], including three cases diagnosed only at birth with normal prenatal US [ 27 , 28 , 29 ]. In other fetal presentations of mediastinal teratoma, diagnosed only at autopsy, tumor differentiation was not mentioned [ 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

“…Second trimester US detection of mediastinal teratomas has been scarcely reported [ 2 , 7 , 8 , 13 , 14 ], including the immature type [ 2 , 7 , 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

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Fetal Presentation of Mediastinal Immature Teratoma: Ultrasound, Autopsy and Cytogenetic Findings

et al. 2021

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Teratomas are the most common congenital tumors, occurring along the midline or paraxial sites, or uncommonly, the mediastinum. Teratomas are classified as mature, containing only differentiated tissues from the three germinal layers; and immature, which also present with neuroectodermal elements, ependymal rosettes, and immature mesenchyme. Herein, we describe a new case of fetal mediastinal immature teratoma detected at 21 weeks of gestational age (wga) + 1 day with thorough cytogenetic analysis. Ultrasound (US) showed a solid and cystic mass located in the anterior mediastinum, measuring 1.8 × 1.3 cm with no signs of hydrops. At 22 wga, US showed a mass of 2.4 cm in diameter and moderate pericardial effusions. Although the prenatal risks and available therapeutic strategies were explained to the parents, they opted for termination of pregnancy. Histology showed an immature teratoma, Norris grade 2. Karyotype on the fetus and tumor exhibited a chromosomal asset of 46,XX. The fetal outcome in the case of mediastinal teratoma relies on the development of hydrops due to mass compression of vessels and heart failure. Prenatal US diagnosis and close fetal monitoring are paramount in planning adequate treatment, such as in utero surgery, ex utero intrapartum therapy (EXIT) procedure, and surgical excision after birth.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Second trimester US detection of mediastinal teratomas has been scarcely reported [ 2 , 7 , 8 , 13 , 14 ], including the immature type [ 2 , 7 , 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

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Fetal Presentation of Mediastinal Immature Teratoma: Ultrasound, Autopsy and Cytogenetic Findings

et al. 2021

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“…43 Fetal mediastinal teratomas often cause second trimester nonimmune hydrops, therefore prognosis is rather poor. [44][45][46][47][48][49][50] In our series, post-mortem histological examination identified immature mediastinal teratoma in one case, which is more rare, tend to grow faster and thus lead to hydrops quicker. 48 In case of smaller tumors or lacking compression of mediastinal organs, prognosis might be better.…”

Section: Discussionmentioning

confidence: 92%

Fetal teratomas – A retrospective observational single‐center study

et al. 2020

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Objective Evaluation of course and outcome of pregnancies with prenatally diagnosed fetal teratomas of various locations in a single center between 2002 and 2019. Methods Retrospective observational single‐center study including prenatally suspected or diagnosed fetal teratomas. Focus was put on ultrasound findings during pregnancy. Complications, need for intervention and outcomes were compared according to tumor location. Results 79 cases of fetal teratomas were seen at our center between 2002 and 2019. Most frequent tumor locations were the sacrococcygeal region (59.5%), neck (20.2%) and oropharynx (7.6%). Complications mainly included polyhydramnios and cardiac compromise. Need for intervention during pregnancy was significantly higher in pericardial teratomas. Preterm birth before 37 and early preterm birth before 32 weeks occurred in 72.7% and 29.1%, respectively. Major causes of perinatal death were tumor bleeding in sacrococcygeal teratomas (SCTs) and respiratory failure in cervical and oropharyngeal teratomas. Conclusion There is a high need for intervention in pregnancies complicated by fetal teratomas. Pericardiocentesis in pericardial teratomas is often inevitable to reduce the risk of intrauterine demise. Amniotic fluid drainage in associated severe polyhydramnios helps to reduce the risk of preterm birth, a major cause of additional morbidity and mortality. MRI in supplement to prenatal ultrasound is useful in fetal teratomas of the neck and oropharynx in order to plan delivery.

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Prenatal sonographic features of fetal mediastinal teratoma

Srisupundit

Sukpan

Tongsong

et al. 2020

J of Clinical Ultrasound

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Mediastinal teratoma can cause severe hydrops fetalis, which worsens the effects of the mass compression on the vital mediastinal organs. A careful sonographic examination is mandatory to demonstrate the characteristic features suggestive of this congenital tumor. We describe these features at 20 weeks gestation. The most prominent finding was the heterogeneous echogenicity of a large cystic‐solid mass with hyperechoic dots, seen as a part of the anterior mediastinum immediately posterior to the sternum. Additional diagnostic features included posterior displacement of the heart, low cardiac output, and hypoplasia of the normally structured heart and lungs due to the direct mass compression. These sonographic findings were confirmed at autopsy which confirmed a nonmetastatic immature teratoma. Sonography may enable accurate diagnosis of mediastinal teratoma considering the anterior location and heterogeneous appearance of the mass, posterior displacement of the heart, normal lung morphology, and compression effects on these organs.

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Fetal mediastinal teratoma: Misinterpretation as congenital cystic lesions of the lung on prenatal ultrasound

Cited by 10 publications

References 14 publications

Fetal Presentation of Mediastinal Immature Teratoma: Ultrasound, Autopsy and Cytogenetic Findings

Fetal Presentation of Mediastinal Immature Teratoma: Ultrasound, Autopsy and Cytogenetic Findings

Fetal teratomas – A retrospective observational single‐center study

Prenatal sonographic features of fetal mediastinal teratoma

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