Neonatal airway obstruction caused by rapidly growing nasopharyngeal teratoma

Maartens, Imke A; Wassenberg, Tessa; Halbertsma, F.J.; Marres, H.A.M.; Andriessen, Peter

doi:10.1111/j.1651-2227.2009.01458.x

Cited by 13 publications

(6 citation statements)

References 15 publications

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“…Surgically, it is aimed to remove the tumor completely. Recurrence may be observed in teratomas which have not been removed completely (1)(2)(3)(4)(5). In our patient, the teratoma was removed nearly completely and tumor was not found on histopathological examination of the biopsy samples obtained from the remnant tissue observed on radiologic follow-up examinations.…”

Section: Discussionmentioning

confidence: 80%

Nasopharyngeal mature teratoma in the newborn

et al. 2014

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Section: Discussionmentioning

confidence: 80%

Nasopharyngeal mature teratoma in the newborn

et al. 2014

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“…As the stomodeum and foregut merge, an outpouching of the ectoderm grows rostrally as Rathke pouch. It is thought that as remnants of endoderm and mesoderm migrate with the ectoderm, these 3 germ layers may become entrapped in the nasopharynx and thus create a nasopharyngeal teratoma 5,7 The most common tissue type is neuroepithelium, and other tissues, including fetal cartilage, myogenic tissue, and epithelium, are often found. Findings from histopathologic examination of the tissue of the present case were rarely positive for desmin, were negative for myogenin, were negative for alpha fetoprotein (AFP), contained many areas positive for S-100, and contained numerous tumor cells positive for glial fibrillary acidic protein.…”

Section: Discussionmentioning

confidence: 99%

Apneic Episodes and Sternal Retractions in an Infant

Harbarger

Prosser

Hughes

et al. 2013

JAMA Otolaryngol Head Neck Surg

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An infant boy known to have a secondary cleft palate presented with apneic episodes and sternal retractions. He had been delivered vaginally at term, with the pregnancy complicated by preeclampsia and oligohydraminos.On examination there was a 3-cm, smooth, whitish tan mass emanating from the right lateral pharyngeal wall (Figure, A) and protruding down through the secondary cleft palate. A contrastenhanced maxillofacial computed tomographic (CT) scan was obtained. This revealed a well-defined, round heterogeneous, midline mass obstructing the oropharynx and posterior nasopharynx (Figure, B-D). The mass had a mildly enhancing thick wall with a central focus of decreased enhancement, with attenuation similar to fluid. No discrete foci of calcification or fat were identified.The child underwent an excision of this mass using the Coblator device (Arthrocare). Intraoperatively, the mass was seen to be pedicled from the right lateral pharyngeal wall in the tonsillar fossa. Findings from nasal endoscopy were unremarkable, with the exception of the mass being visible in the nasopharynx. He tolerated this procedure well and 6 months later underwent a palatoplasty for repair of the secondary cleft palate.What is your diagnosis?

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“…Prenatally, CNMs may present with polyhydramnios due to impaired swallowing. 6,11,19,23,24,29 Elevated maternal alpha-fetoprotein levels may also be present. 10,11,17,30 Ultrasound may detect these lesions.…”

Section: Discussionmentioning

confidence: 99%

An Approach to Nasopharyngeal Mass in Newborns: Case Series and Systematic Literature Review

Noy¹,

Borenstein-Levin²,

Gordin³

2022

Rambam Maimonides Med J

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Objective: Congenital nasopharyngeal masses (CNMs) are rare. Presenting symptoms vary, and the differential diagnoses cover a wide spectrum of possibilities. As it is uncommon, most examples discussed in literature are described as case reports or series. Guidelines on CNM patient management do not exist. In this study, we present two (2) cases of neonates with CNMs that were encountered at our tertiary center. Additionally, to best elaborate a comprehensive, case-based approach to CNM management, we offer an up-to-date, diagnosis-to-treatment review of current literature. Methods: Case series and systematic literature review. Results: Twenty-eight (28) studies are included since January 2000 to October 2021, with a total of 41 cases. Most common diagnosis was teratoma (78%). Female-to-male ratio was 2.5:1. Twenty percent of cases presented prenatally with polyhydramnios or elevated alpha-fetoprotein. Postnatally, the presenting symptoms most frequently encountered were respiratory distress (78%), oral mass (52%), and feeding difficulties (29%). Seventy-five percent of affected newborns showed symptoms within the first 24 hours of life. Forty percent of cases had comorbidities, especially in the head and neck region. Conclusions: Congenital nasopharyngeal masses can be detected antenatally, or symptomatically immediately after birth. Airway protection is a cornerstone in the management. Selecting the right imaging modality and convening a multidisciplinary team meeting are important toward the planning of next steps/therapeutic approach. Typically, a transnasal or transoral surgical approach will be deemed sufficient to address the problem, with a good overall prognosis.

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Neonatal airway obstruction caused by rapidly growing nasopharyngeal teratoma

Abstract: Epignathus is a rare cause of upper airway obstruction of the newborn that can grow rapidly in the neonatal period.

Cited by 13 publications

References 15 publications

Nasopharyngeal mature teratoma in the newborn

Nasopharyngeal mature teratoma in the newborn

Apneic Episodes and Sternal Retractions in an Infant

An Approach to Nasopharyngeal Mass in Newborns: Case Series and Systematic Literature Review

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