A huge immature cervical teratoma; Antenatal diagnosis, and its management - An unusual entity

Abstract

Cervical teratomas are not reported quite frequently in medical literature, especially from Indian subcontinent. Prenatal diagnosis of this condition is even rarer, making the management protocols difficult. In absence of prompt intervention in the form of airway decompression, morbidity and mortality is very high. Presented here is the case of antenatal diagnosed cervical mass, which was managed successfully in immediate post-natal period with uneventful survival and normalized tumor marker levels.

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

“…Literature search revealed only a few surviving cases of giant cervical immature teratoma. [2] Antenatal scans at times may not identify the mass as in the cases reported by Gezer et al . [4] The reasons for morbidity and mortality of giant cervical teratomas are airway obstruction, pressure on cervical neurovascular structures and comorbid factors…”

“…Cervical teratomas constitute 1.6%–9.3% of all pediatric teratomas. [12] They can present antenatally with cervical mass or polyhydramnios and postnatally with respiratory distress and facial disfigurement. Surgical outcome and survival depend on preexisting pressure effects, operative injuries to the vital structures, and also coexisting comorbidities.…”

Three-step management of a newborn with a giant, highly vascularized, cervical teratoma: a case report

“…Another neurological sequela was an abduction weakness of her right shoulder which slowly recovered. Neck teratomas can arise from and completely replace the thyroid tissue [1]. Thyroid function tests demonstrated hypothyroidism and she started receiving thyroid replacement therapy.…”

“…Congenital teratomas (from the Greek “ téras oma ” meaning “monstrous tumor”) are rare tumors (1 per 40,000 births [1]) containing tissues derived from all three primordial embryonic layers [2]. The most common site is the sacrococcygeal region.…”

“…In some cases, genetic changes in the tumor cells were demonstrated and include 1p21.1 amplification, 9p22 deletion, and 17q21.33 1-copy gain [5]. Associated malformations are rare and include gastrointestinal (for example, imperforate anus), cardiac (for example, hypoplastic left heart syndrome), and neurological (for example, absence of corpus callosum and arachnoid cysts) defects [1].…”