Fetal neck tumors – antenatal and intrapartum management

Kornacki, Jakub; Skrzypczak, Jana

doi:10.5603/gp.a2017.0050

Cited by 12 publications

(19 citation statements)

References 17 publications

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“…Differential diagnosis of congenital cystic neck mass includes germ cell tumor, vascular malformation, and thymic cyst, while cervical myelomeningocele and brachial cleft cyst are uncommon. [10,13,14] Signal characteristic of lymphangioma on MRI is usually hyperintense on T2W with variable intensity on T1W depending on protein content. [15] Fluid-fluid level can be seen in cases complicated by hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

The Value of Fetal Magnetic Resonance Imaging in Giant Lymphangioma: A Case Report

Wirasasmita¹,

Yani²,

Besar³

et al. 2018

J Clin Res Radiol

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A giant lymphangioma at the neck, axillary, chest wall up to abdominal wall, and extension into upper thoracic cavity and the right upper extremity is reported. Ultrasound examination during antenatal care revealed huge cyst lesion with septation. Magnetic resonance imaging was performed at 36 weeks of gestation to determine tissue characteristic, evaluate tumor extension especially into thoracic chest cavity for looking any compression vital structure such as airways, vascular, therefore can prepare of technique delivery of the baby and surgical planning after birth as well. Tracheoesophageal displacement index (TEDI) was measured more than 12. Fetal karyotype shows male karyotype with double deletion on chromosome 17. The baby has been operated 3 times. Histopathological result was lymphangioma. Intralesional bleomycin of 0.5 mg/kg is given post operation.

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Section: Discussionmentioning

confidence: 99%

The Value of Fetal Magnetic Resonance Imaging in Giant Lymphangioma: A Case Report

Wirasasmita¹,

Yani²,

Besar³

et al. 2018

J Clin Res Radiol

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“…Es muy importante determinar el tamaño de la lesión y monitorizarlo. Tanto la ecografía como la RM permiten diferenciar el componente sólido o quístico de una lesión 18,20 . Suele utilizarse la combinación de estas modalidades de imágenes 14,21 .…”

Section: Imágenesunclassified

“…Estos están relacionados a la dosis utilizada y son transitorios 28,30 . Una revisión sistemática sobre el uso de sirolimus para MVL fue publicada en 2018 20 . Los estudios incluidos fueron todos de carácter retrospectivo, con un total de 71 pacientes, con remisión parcial en el 84,5% de los pacientes.…”

Section: Tratamiento Médico Sistémicounclassified

“…Esta técnica permite, en una cesárea programada, asegurar la vía aérea fetal mediante intubación, broncoscopía o TQT, mientras la oxigenación fetal se mantiene mediante la circulación placentaria. Para llevarla a cabo se requiere de un equipo multidisciplinario que trabaje en forma coordinada, compuesto por al menos especialistas en: ginecología, otorrinolaringología, cirugía infantil, anestesia, neonatología y enfermeras 20,21,42,43 . En una serie de 13 casos de MVL cervical (7 de ellos con diagnóstico antenatal), se realizó EXIT logrando intubación nasotraqueal con éxito en 4 pacientes, logrando una supervivencia inicial de 100%.…”

Section: Exit (Ex-utero Intrapartum Therapy)unclassified

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Malformaciones vasculares linfáticas de cabeza y cuello en pacientes pediátricos: revisión de la literatura

García¹,

Reyes²,

Petit-Breuilh³

et al. 2020

Rev. Otorrinolaringol. Cir. Cabeza Cuello

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“…Fetal tumors are rare congenital anomalies, with an estimated incidence of 1/12,000 to 1/30,000 births. [1] Among them, fetal cervical cysts [2,3] , such as lymphangioma, [4] represent an important group of tumors. Fetal cervical cysts are soft, benign, and occur by fluid-filled cystic dilation, and are typically found in the posterior triangle of the neck.…”

Section: Introductionmentioning

confidence: 99%

Fetal giant right cervical cyst causing severe tracheal compression

Kang

Jiang

et al. 2019

Medicine

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Rationale: Fetal giant cervical cyst (FGCC) is a rare congenital anomaly. Sometimes FGCC may extend into the mediastinum, and result in severe tracheal compression, which is a life-threatening event at birth. Patient concerns: We present a rare case of FGCC, which extended from the right neck into the superior mediastinum, and resulted in severe tracheal compression. Diagnoses: An FGCC was observed by ultrasonography and magnetic resonance imaging (MRI) at 27+4 weeks’ gestation (WG). Fetal MRI at 35+1 WG showed that the FGCC was 3.3 × 8.2 × 7.5 cm and extended from the right neck into the superior mediastinum. Severe tracheal compression was observed and the inside diameter of the narrowest section of tracheostenosis appeared thread-like and measured only 0.1 cm. Interventions: Cervical cyst reduction was performed prenatally under ultrasound guidance to alleviate the tracheal compression and maximize the chance of fetal survival 2 days before birth. At 36+3 WG, cesarean section was performed, and a female neonate was immediately delivered and intubated (3.5-mm tube) by an experienced anesthesiologist. Neonatal intralesional sclerotherapy and cystic component aspiration as guided by digital subtraction angiography were performed under general anesthesia. Anesthesia was maintained only with sevoflurane 3% in 2 L/min oxygen. Extubation was performed soon after surgery. Outcome: The neonate recovered uneventfully and was discharged 2 days postoperatively. After 140 days of follow-up, the neonate had recovered completely. Lessons: If an FGCC is suspected by abdominal ultrasound, a fetal MRI is recommended to assess the severity of tracheal compression before birth, if feasible. An anesthesiologist should assess the risk of intubation failure at birth according to those results. If fetal severe tracheal compression is detected and it may result in inability of intubation at birth, prenatal cervical cyst reduction under ultrasound guidance may be effective for alleviating tracheal compression at birth, if feasible. This could maximize the chance of fetal survival. Improvement of fetal short- and long-term outcomes is important.

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Fetal neck tumors – antenatal and intrapartum management

Cited by 12 publications

References 17 publications

The Value of Fetal Magnetic Resonance Imaging in Giant Lymphangioma: A Case Report

The Value of Fetal Magnetic Resonance Imaging in Giant Lymphangioma: A Case Report

Malformaciones vasculares linfáticas de cabeza y cuello en pacientes pediátricos: revisión de la literatura

Fetal giant right cervical cyst causing severe tracheal compression

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