Perinatal management of a lingual teratoma.
BACKGROUND
Teratomas of the head and neck are rare and occur almost exclusively in neonates. Prenatal diagnosis of these tumors allows for a carefully planned delivery that maintains an open airway and potentially improves perinatal outcome. We report the perinatal management of a huge intrapharyngeal and intra-oral teratoma that had a broad connection to the base of the tongue.


METHODS
An anterior neck mass (5 x 5 cm) in an otherwise normal-appearing fetus was detected at 19 weeks' gestation. The mass increased in size over the next 10 weeks to 8 x 6.8 x 4.3 cm. Marked fetal head deflexion was noted along with concomitant hydramnios. The mother had spontaneous rupture of membranes with preterm labor at 29 weeks' gestation. A 1860-g male neonate was delivered by classical cesarean delivery. A tracheostomy was performed in the delivery room for ventilation after the upper airway could not be accessed by bronchoscopy. Histologic examination after surgical excision confirmed a congenital teratoma with immature neuroectodermal tissue and alpha-fetoprotein-bearing endodermal sinus tumor components with exclusively polyvesicular vitelline characteristics. The origin of the pharyngeal mass was the base of the tongue.


CONCLUSIONS
The prenatal diagnosis of a pharyngeal teratoma should prompt a careful delivery plan to optimize perinatal outcome.
McMahon
M J
MJ
Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill School of Medicine, USA.
Chescheir
N C
NC
Kuller
J A
JA
Wells
S R
SR
Wright
L N
LN
Nakayama
D K
DK
D000328:Adult; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010610:Pharyngeal Neoplasms / Q000151:congenital / Q000000981:diagnostic imaging / Q000601:surgery; D011247:Pregnancy; D013724:Teratoma / Q000151:congenital / Q000000981:diagnostic imaging / Q000601:surgery; D014062:Tongue Neoplasms / Q000151:congenital / Q000000981:diagnostic imaging / Q000601:surgery; D016216:Ultrasonography, Prenatal