Fetal teratomas – A retrospective observational single‐center study

Abstract

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.

Smart Shape‐Memory Polymeric String for the Contraction of Blood Vessels in Fetal Surgery of Sacrococcygeal Teratoma

“…Despite the imposition of stringent standards in terms of technical expertise and operating conditions, this technique resulted in intrauterine deaths and preterm births owing to tumor regrowth, tumor necrosis, and bleeding. [25,26] Therefore, further advances in functional biomaterials that resolve these difficulties are of considerable importance.…”

Percutaneous versus Open Fetal Surgical Intervention for Sacrococcygeal Teratomas: Is Less Really More?

“…Theoretically, if a percutaneous procedure was successful at occluding arterial inflow to the tumor, tissue ischemia and necrosis would cause release of cellular potassium or inflammatory mediators into the circulation of an already sick fetus and hasten fetal hydrops and demise. Indeed, we found there are many cases reported in which fetal demise occurred within days to a week following PIs for solid tumors [16, 17, 24, 25, 27] (Table 2). Likely, strategies should aim to occlude the venous and lymphatic drainage in addition to arterial inflow of these rapidly growing tumors.…”

“…The very first interventions described utilized an open surgical technique to achieve either complete or partial tumor resections and were successful in reversing hydrops [8]. In more recent years, alternative methods of interventions that utilize a percutaneous approach have arisen, including laser vascular ablation, radiofrequency vascular ablation, vascular sclerosis, vascular coiling for solid tumors, and aspiration, shunting, and unroofing for cystic tumors [7,[9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]. For both open and percutaneous approaches, the procedures are high risk and may cause early rupture of membranes, preterm labor, or fetal demise.…”

Case report: Fetal cervical immature teratoma and copy number variations

“…Corinna et al. ( 16 ) found a female-to-male ratio of 1:1 in teratomas of the neck through analyzing 79 cases of fetal teratoma between 2002 and 2019. Their research indicates that female fetuses potentially have a higher incidence of teratoma.…”