Management of Congenital Cervical Teratoma with Application of EXIT Protocol - Case Report

Abstract

Background: Congenital teratomas are relatively rare neoplasms, which occurs in about 1:20,000 to 1:80,000 births, and only 1.5% to 5% of which are neoplasm of the cervical. They can be diagnosed through ultrasound during pregnancy and, if not properly handled, have a high mortality rate. Airway compression is a secondary complication following mortality. Case report: A solid-cystic mass was identified in the anterior cervical region of a 30-week-old fetus during an ultrasound scan. EXIT (Ex-Utero Intrapartum Treatment)-to-airway procedure was performed by a multidisciplinary team composed of obstetricians, anesthesiologists, neonatologists and pediatric surgeons to remove the neoplasm. The procedure occurred upon delivery of the fetus, resulting in a positive outcome with neonatal survival. In this case, the fetus was in breech position, and, differently from the usual EXIT protocol, it had to be completely extracted before guaranteeing airway flow. Conclusion: Although congenital teratomas are a rare condition with complex treatment, it is possible to achieve a satisfactory outcome when adequate planning and protocol are established.