Case Report: Severe acute respiratory distress by tracheal obstruction due to a congenital thyroid teratoma.

Abstract

Congenital teratoma is a rare condition and is a germ cell tumor composed of elements from one or more of the embryonic germ layers and contain tissues usually foreign to the anatomic site of origin. We report a case of a neck tumor diagnosed during pregnancy, initially thought to be a goiter. After birth the neck mass kept growing until it compressed the trachea and produced respiratory failure. The infant had a difficult tracheal intubation because of the compressing mass. The staff decided to surgically remove the neck mass. After that, the infant became eupneic. The histological analysis showed a mature teratoma with no atypias.

Diagnosis and Management of Fetal Cervical Masses

“…2 A less prevalent form of HAE with normal C1 inhibitor (HAE-nC1-INH) has the distinctive charac-teristic of showing normal complement levels and affects mainly women, while men are often asymptomatic carriers. 3 In the largest Portuguese cohort that included 126 patients, HAE-nC1-INH was diagnosed in five patients (4%). 4 The pathophysiology of HAE-nC1-INH is unknown, although evidence suggests the role of excess generation of bradykinin, causing vasodilation and vascular permeability.…”

“…5 However, pregnancy has shown a variable course in intensity and frequency of the attacks, even in the same patient, suggesting that the hormonal changes are not the only influencing factors. 3 Mechanical trauma due to uterine growth and fetal movements have also been proposed as aggravating factors. 3 However, a recent study revealed that attacks were more common during the first trimester (41.7%).…”

“…3 Mechanical trauma due to uterine growth and fetal movements have also been proposed as aggravating factors. 3 However, a recent study revealed that attacks were more common during the first trimester (41.7%). 3 Moreover, symptoms during pregnancy may be misdiagnosed, especially if the timing matches that of the onset Bebiana SOUSA 1 , Maria João OLIVEIRA 2 , Ribeiro CASTRO 3 , Ana Cristina FREITAS 4 , Luís GUEDES-MARTINS 5,6,7…”

“…2 Mortality can reach 80% if not properly treated, mainly due to obstructive respiratory complications. 3 The EXIT procedure has revolutionized the management of congenital malformations with upper airway obstruction. 4 Surgical excision should be performed expeditiously to reduce respiratory impairment and to prevent complications such as ulceration, infection, coagulopathy and malignant transformation.…”