Prenatal Evaluation of Bidirectional Epignathus: Comparison of Ultrasonography and Magnetic Resonance Imaging

Abstract

Epignathus is an unusual, benign, congenital teratoma of the hard palate. Most of these teratomas are unidirectional and protrude through the mouth. Hence, the prognosis depends on the size of the tumor and degree of face distortion and airway obstruction. Occasionally, intracranial extension of the tumor is present, involving and destroying the brain tissue, resulting in a poor prognosis. The authors describe 2 cases of bidirectional epignathus, showing the different findings on ultrasonography and magnetic resonance imaging.

A case of an epignathus with intracranial extension appearing as a persistently open mouth at 16 weeks and subsequently diagnosed at 20 weeks of gestation

“…Most of these teratomas are unidirectional and protrude through the mouth. Cases with intracranial extension causing destruction of the brain tissue have poor prognosis 7, 8. Prenatal sonographic diagnosis of large protruding oral tumors is easy 9.…”

Oral teratoma-the devil’s curse: a case report

“…It is always associated with polyhydramnios. 8 Total Resection is the treatment of choice, as there may be a small chance of malignant transformation in due course of time and also there is difficulty in feeding and breathing. 9 Pure oral teratomas are rare and reported very less in literature.…”

Prenatal diagnosis and management of fetal pharyngeal teratoma: A case report and review of the literature

“…Sonography may be sufficient for this task, though MRI can delineate the teratoma more precisely. 7,18 Optimal management requires prenatal diagnosis. Pregnancy termination is an option when there is intracranial spread of the teratoma.…”