Facial Teratoma in the Newborn: Diagnosis and Prognosis

Facial teratoma is an extremely rare germinal tumor in newborn babies. It is often diagnosed antenatally by means of ultrasound and even MRI. The prognosis of this tumor depends mainly on the size and the location of the lesion (eye, respiratory and digestive tracts). Multidisciplinary examination is needed to ensure the newborn’s survival. Pre-operative conditioning is needed to avoid complications and carcinogenic risks. The aim of this article is to Specify the anatomical features of facial teratoma and consider the interests of foetopathology review. We report a male baby, prematurely born at 28 WA dead at hour 23. Physical examination reveals a frontal mass on the left side of the face plus a facial dysmorphia. Dissection shows hyperplasia of lungs, hypertrophied liver and a splenomegaly. Histological examination reveals neural tissue associated with areas of cartilage and hair; hence the diagnosis of congenital teratoma of the face. Antenatal diagnosis of congenital teratoma of the face is very crucial allowing a multidisciplinary care involving obstetricians, neonatologists, surgeons and anesthesiologists

Neonatal Tumors

Neonatal tumors encompass a group of heterogeneous neoplasms that demonstrate anatomic locations, behavior patterns, histologic features, and treatment responses that are distinct from neoplasms found in older children. The majority of neonatal tumors are benign, with malignant lesions accounting for only 2% of childhood cancers. However, histologically benign tumors can lead to detrimental effects on the fetus and newborn due to their size and location in relation to vital structures. An understanding of the incidence, appearance, and typical locations of neonatal tumors can provide important diagnostic information and guide treatment decisions. Although surgical intervention is the mainstay of therapy for many neonatal tumors, it is important to recognize that some lesions will regress spontaneously, whereas others may respond to noninvasive treatment modalities. In this chapter, we explore the epidemiology of neonatal tumors and provide a location-based classification schema to aid in diagnosis. A summary of the presentation, diagnosis, and management of the most common neonatal tumors is provided as well

Prenatal Ultrasound Findings of Fetal Neoplasms

A variety of neoplasms can develop in each tetal organ. Most fetal neoplasms can be detected by careful prenatal ultrasonographic examination. Some neoplosms show specific ultrasonographic findings suggesting the differential diagnosis, but others do not. Knowledge of the presence of a neoplasm in the fetus may alter the prenatal management of a pregnancy and the mode of delivery, and facilitates immediate postnatal treatment. During the last five years, we experienced 32 cases of fetal neoplasms in a variety of organs. We describe their typical ultrasonographic findings with correlating postnatal CT, MRI, and pathologic findings

Challenges in the prenatal and post-natal diagnosis of mediastinal cystic hygroma: a case report

<p>Abstract</p> <p>Introduction</p> <p>Cystic hygroma is a benign congenital neoplasm that mostly presents as a soft-tissue mass in the posterior triangle of the neck. Pure mediastinal lesions are uncommon; the vast majority are asymptomatic and are an incidental finding in adulthood. The diagnosis is often made intra- or postoperatively. Prenatal identification is exceptional and post-natal diagnosis also proves challenging.</p> <p>Case presentation</p> <p>We report one such case that was mistaken for other entities in both the prenatal and immediate post-natal period. Initial and follow-up antenatal ultrasound scans demonstrated a multicystic lesion in the left chest, and the mother was counselled about the possibility of her baby having a congenital diaphragmatic hernia. Initial post-natal chest radiographs were reported as normal. An echocardiogram and thoracic computed tomography scan confirmed a complex multiloculated cystic mediastinal mass. The working diagnoses were of a mediastinal teratoma or congenital cystic adenomatous malformation. At operation, the lesion was compressed by the left lung and was found to be close to the left phrenic nerve, which was carefully identified and preserved. After excision, histopathological examination of the mass confirmed the diagnosis of cystic hygroma. Postoperative dyspnoea was observed secondary to paradoxical movement of the left hemidiaphragm and probable left phrenic neuropraxia. This settled conservatively with excellent recovery.</p> <p>Conclusion</p> <p>Despite the fact that isolated intrathoracic cystic hygroma is a rare entity, it needs to be considered in the differential diagnosis of foetal and neonatal mediastinal masses, particularly for juxtadiaphragmatic lesions. The phrenic nerve is not identifiable on prenatal ultrasound imaging, and it is therefore understandable that a mass close to the diaphragm may be mistaken for a congenital diaphragmatic hernia because of the location, morphology and potential phrenic nerve compression. Post-natal diagnosis may also be misleading as many mediastinal cystic masses have similar appearances on imaging. Therefore, as well as cystic architecture, special consideration needs to be given to the anatomical location and effect on local structures.</p

Congenital tumors: imaging when life just begins

BACKGROUND: The technical developments of imaging methods over the last 2 decades are changing our knowledge of perinatal oncology. Fetal ultrasound is usually the first imaging method used and thus constitutes the reference prenatal study, but MRI seems to be an excellent complementary method for evaluating the fetus. The widespread use of both techniques has increased the diagnosis rates of congenital tumors. During pregnancy and after birth, an accurate knowledge of the possibilities and limits of the different imaging techniques available would improve the information obtainable, thus helping the medical team to make the most appropriate decisions about therapy and to inform the family about the prognosis. CONCLUSION: In this review article, we describe the main congenital neoplasms, their prognosis and their imaging characteristics with the different pre- and postnatal imaging methods available

Fetal tracheolaryngeal airway obstruction: prenatal evaluation by sonography and MRI

We reviewed the sonographic and MRI findings of tracheolaryngeal obstruction in the fetus. Conditions that can cause tracheolaryngeal obstruction include extrinsic causes such as lymphatic malformation, cervical teratoma and vascular rings and intrinsic causes such as congenital high airway obstruction syndrome (CHAOS). Accurate distinction of these conditions by sonography or MRI can help facilitate parental counseling and management, including the decision to utilize the ex utero intrapartum treatment (EXIT) procedure

Case report and review of the literature: rare fetus-in-fetu presenting as oropharyngeal epignathus

An epignathus is caused by a continuous spectrum of masses of the oral cavity or oropharynx ranging in its entity from mature teratoma to the exceedingly rare fetus-in-fetu. Due to its location, regardless of the entity, the occurrence of an epignathus is frequently associated with life threatening airway obstruction. Here we demonstrate a case of a fetus-in-fetu presenting as an epignatus. We describe its successful management and review the available literature. Early diagnosis and knowledge of the preoperative workup are essential to enable a multidisciplinary management. Once the airway is secured, surgical excision is the treatment of choice often resulting in a good clinical outcome and prognosis