Huge congenital cervical immature teratoma mimicking lymphatic malformation in a 7-day-old male neonate

Teratomas are a conglomerate of heterogenous cells arising from totipotent germ cells. Cervical teratomas occur 1 per 20,000 to 40,000 live births constituting 1.6-9.3% of all paediatric teratomas. They can present antenatally with cervical mass or polyhydramnios and postnatally with respiratory distress and facial disfigurement. Complete excision of the tumour prevents malignant transformation. Timing of the surgery is based on severity of airway compromise. Surgical outcome and survival depend on pre-existing pressure effects, operative injuries to the vital structures and also co-existing comorbidities. One such complicated case of giant cervical teratoma is described here.

show abstract

“…[5] If airway is not secured, an aggressive surgical exploration has to be done by a team with adequate expertise. [6]…”

Section: Discussionmentioning

confidence: 99%

Cervical giant immature teratoma in a newborn: A challenge for survival

Kumbha¹,

Rohita²,

Reddy³

et al. 2019

J Indian Assoc Pediatr Surg

View full text Add to dashboard Cite

show abstract

“…Teratomas are congenital tumors composed of tissue derived from all 3 embryonic germ cell layers and occur in approximately 1 in 20 000 to 40 000 live births. 1,2 Pluripotent cells are believed to deviate during the fourth to fifth gestational week and differentiate to varying degrees, categorizing as immature or mature, with solid to cystic architecture. 2,3 Teratomas are commonly located in the sacrococcyx but may present in the gonads, anterior mediastinum, or retroperitoneum.…”

Section: Discussionmentioning

confidence: 99%

“…2,3 Teratomas are commonly located in the sacrococcyx but may present in the gonads, anterior mediastinum, or retroperitoneum. 1 Head and neck, or cervical, teratomas account for 3% to 5% of all pediatric teratomas. They typically present in the midline or anterolateral aspect of the neck or the oropharynx and frequently displace or splay the thyroid gland.…”

Section: Discussionmentioning

confidence: 99%

Newborn With a Sublingual Mass

Dionisio

Harb

Scott

2019

JAMA Otolaryngol Head Neck Surg

View full text Add to dashboard Cite

A 1-week-old, full-term male newborn presented with increasingly labored breathing, xerostomia, and poor bowel movements. He had been born after an uncomplicated pregnancy, during which routine prenatal ultrasonography had not detected any anatomical abnormalities or lesions. On physical examination, there were no abnormalities other than symmetrical submucosal swelling of the floor of the mouth and a midline external punctum present in the submental area (Figure , A). The tongue was displaced posteriorly and superiorly. Contrast-enhanced magnetic resonance imaging of the neck and face performed shortly after presentation showed a midline sublingual lesion extending inferiorly through the mylohyoid muscle (Figure , B-D). The intrinsic muscles of the tongue appeared minimally displaced without obvious infiltration; however, the genioglossus muscle was difficult to locate relative to the mass. A thin-walled, multiloculated lesion was identified, measuring approximately 2.0 × 2.5 × 3.2 cm. The mass was bright on T2-weighted imaging and dark on T1-weighted imaging and did not enhance with intravenous gadolinium. There were no obvious fluid-fluid levels or calcifications. When in-phase and out-of-phase images were compared, there was no significant signal intensity drop, suggesting an absence of fat within the lesion. Diagnosis B. Cystic teratoma (mature)

show abstract

“…Cervical teratomas account for 2% to 9% of all pediatric teratomas. 5 Teratomas of the neck are described in numerous case reports [6][7][8][9][10][11][12][13][14][15] and case series [16][17][18][19][20][21][22][23][24] which report that these tumors can grow to massive size. Aggressive growth can jeopardize the esophagus, increasing risk for polyhydramnios and preterm birth.…”

Section: Cervical Teratomasmentioning

confidence: 99%

“…In this case, the right-sided location of the tumor likely caused the compromise of venous return that resulted in fatal hypoxic injury to the brain. Although cases of right-sided cervical teratomas have been reported, 6,16,17,30 none described the occurrence of SVCS, implying not only position but also size is necessary for sufficient compression.…”

Section: Cervical Teratomasmentioning

confidence: 99%

Superior Vena Cava Syndrome and Hypoxic Ischemic Encephalopathy Secondary to a Massive, Right-Sided Immature Cervical Teratoma

et al. 2019

View full text Add to dashboard Cite

Cervical teratomas are a rare form of fetal teratoma that can grow to massive size. Generally, these masses can be surgically excised after birth with excellent physical and functional prognosis because the benign variants respect anatomical borders. The primary complications of these masses are associated with compromise of the trachea and esophagus: upper airway obstruction and polyhydramnios. We report the first documented occurrence of superior vena cava syndrome and hypoxic ischemic encephalopathy associated with a massive, right-sided cervical teratoma. This case highlights that when cervical teratomas are right-sided and sufficiently large, they can extend inferiorly and compromise central venous return to the heart. This unique presentation would likely have required fetal surgical excision to avoid catastrophic cerebral injury.

show abstract

Huge congenital cervical immature teratoma mimicking lymphatic malformation in a 7-day-old male neonate

Cited by 6 publications

References 12 publications

Cervical giant immature teratoma in a newborn: A challenge for survival

Cervical giant immature teratoma in a newborn: A challenge for survival

Newborn With a Sublingual Mass

Superior Vena Cava Syndrome and Hypoxic Ischemic Encephalopathy Secondary to a Massive, Right-Sided Immature Cervical Teratoma

Contact Info

Product

Resources

About