Prenatal ultrasonographic diagnosis of intracranial teratoma and massive craniomegaly with associated high-output cardiac failure

Sherer, David M.; Abramowicz, Jacques S.; Eggers, Paula; Metlay, Leon A.; Sinkin, Robert A.; Woods, James R.

doi:10.1016/s0002-9378(12)90893-5

Cited by 30 publications

(12 citation statements)

References 2 publications

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“…One case of hypercardiac performance was reported in massive teratoma [7]. Our case also demonstrated dilated cardiac dimension and increased fractional shortening.…”

Section: Discussionsupporting

confidence: 59%

Fetal Glioblastoma: Rapid Growth during the Third Trimester

Kamitomo

Sameshima²,

Uetsuhara³

et al. 1998

Fetal Diagn Ther

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We present a case of fetal glioblastoma which appeared after 28 weeks’ gestation. The first ultrasonographic finding was an enlarged fetal head with right shifted falx cerebri at 31 weeks’ gestation. At 33 weeks, a large and high echogenic mass in the left hemisphere and right enlarged ventricle was identified. Magnetic resonance imaging showed that the tumor was localized in the left hemisphere and a margin of the tumor was defined. Because fetal well-being judging from biophysical parameters was good and we considered that the tumor was resectable, a male fetus weighing 2,670 g was delivered at 34 weeks’ gestation by cesarean section. However, he was inoperable due to consumptive coagulopathy and rapid growth of the tumor, and died on the 41st day of life.

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“…One case of hypercardiac performance was reported in massive teratoma [7]. Our case also demonstrated dilated cardiac dimension and increased fractional shortening.…”

Section: Discussionsupporting

confidence: 59%

Fetal Glioblastoma: Rapid Growth during the Third Trimester

Kamitomo

Sameshima²,

Uetsuhara³

et al. 1998

Fetal Diagn Ther

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“…Teratomas appear to have mixed (solid and cystic) parts distorting the brain anatomy. In massive forms, neither normal cerebral structure, nor midline echo or ventricular system can be identified [1][2][3]. Tumors are more commonly supratentorial, although a precise location is not possible in large or hemorrhagic masses.…”

Section: Discussionmentioning

confidence: 99%

“…Intense vascularization and low resistance flows have been observed at color Doppler examination. High-output cardiac failure with fetal hydrops has been reported, probably due to the tumor's wide arteriovenous shunts [2].…”

Section: Discussionmentioning

confidence: 99%

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Prenatal Sonographic Imaging of an Immature Intracranial Teratoma

Pinto

Meo²,

Loiudice³

et al. 1999

Fetal Diagn Ther

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This article describes the prenatal sonographic diagnosis of a rare case of intracranial immature teratoma in a fetus at the 35th week of gestation which looked normal at previous examinations. At sonography a markedly enlarged fetal head containing a complex irregular mass and hydrocephalus was detected. Color Doppler examination of the mass showed intense vascularization with low resistance flows.

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“…The effect of the craniofacial teratoma on the fetal circulation can be documented by Doppler flow study and echocardiography. Doppler flow study may demonstrate high-volume and high-velocity flow of the tumor and echocardiography may reveal dilated ventricles in association with high-output cardiac failure due to massive tumor arteriovenous shunting 17 . 3D color power angiography further provides a perfusion display of the vasculature, thus allowing visualization of the blood flow between the tumor and fetal circulation and an understanding of the hemodynamic pathophysiology.…”

Section: Two-and Three-dimensional Ultrasound Demonstration Of a Gianmentioning

confidence: 99%

Two‐ and three‐dimensional ultrasound demonstration of a giant epignathus

Chen

Shih

Huang

et al. 2003

Ultrasound in Obstet & Gyne

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A 41-year-old woman, gravida 6 para 3, was referred to hospital in the second trimester for genetic amniocentesis. She and her husband were non-consanguineous and healthy. There was no family history of congenital malformations. She did not have teratogenic medication, recent infection, diabetes mellitus, or hypertension during this pregnancy. Her previous pregnancies resulted in two miscarriages and uneventful deliveries of three healthy children. Amniocentesis revealed a 46,XY karyotype in this pregnancy. A detailed two-dimensional (2D) ultrasound examination at 17 weeks' gestation revealed a single live fetus with a biparietal diameter of 3.4 cm (equivalent to 16 weeks' gestation), an abdominal circumference of 13.1 cm (equivalent to 18 weeks' gestation), a femur length of 2.1 cm (equivalent to 16 weeks' gestation), a normal amniotic fluid index of 16.8 cm, and a giant mixed echogenic mass measuring 8.1 × 4.8 × 7.1 cm in the left face in continuation with the skull. The intracranial structures were intact. Doppler flow study showed a high-volume and high-velocity flow within the tumor. Echocardiography was normal. The left orbit was absent. The nose and mouth were difficult to identify. There was no fetal head movement. Three-dimensional (3D) ultrasound displayed a giant left facial mass ( Figure 1a). 3D color power angiography showed that the large facial tumor parasitized blood supply from the fetal circulation. A tentative diagnosis of epignathus was made. The woman opted for termination of the pregnancy. A 372-g male fetus with epignathus was delivered (Figures 1b and 2a). Autopsy revealed a teratoma arising from the palate without involving the skull and brain. Cytogenetic analysis of the teratoma revealed a 46,XY karyotype. Multiple transectional skull computed tomography scans showed intralesional calcification and an intact skull. Magnetic resonance imaging scans showed a giant facial mass distorting the skull and brain structures (Figure 2b).An epignathus is a rare teratoma of the oropharynx with an incidence between 1 in 35 000 and 1 in 200 000 live births 1 . The majority of epignathi originate from the base of the skull in the posterior nasopharynx and usually involve the hard palate or sphenoid bone 2 . Cleft palate and bifid tongue or nose may be present 3 . A few epignathus teratomas have been associated with chromosome aberrations, such as 45,X/46,X,r(X) mosaicism 3 , trisomy 13 4 , duplication of 1q and 19p 5 , and inverted proximal 1q duplication 3 . Prenatal diagnosis of epignathi by 2D ultrasound has been well documented 1 -16 . However, to our knowledge, 3D ultrasound demonstration of an epignathus has not yet been described. The 2D ultrasound features of epignathi include a mass projecting from the oral cavity, a mass adjacent to the face with or without intracranial extension, polyhydramnios, and hydrops fetalis. Fetal prognosis depends on the extent of the neighboring tissue involvement and the size of the tumor. Fetuses with a bidirectional epignathus invading the intracranial struct...

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Prenatal ultrasonographic diagnosis of intracranial teratoma and massive craniomegaly with associated high-output cardiac failure

Cited by 30 publications

References 2 publications

Fetal Glioblastoma: Rapid Growth during the Third Trimester

Fetal Glioblastoma: Rapid Growth during the Third Trimester

Prenatal Sonographic Imaging of an Immature Intracranial Teratoma

Two‐ and three‐dimensional ultrasound demonstration of a giant epignathus

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