High resolution computed tomography in neonatal nasopharyngeal teratoma

Neonatal nasopharyngeal teratomas: cross sectional imaging features

BACKGROUND

Neonatal nasopharyngeal teratomas are extremely rare and there are few reports describing both CT and MRI features of these lesions.

OBJECTIVE

To describe the CT and MRI appearances of neonatal nasopharyngeal teratoma.

MATERIALS AND METHODS

Three neonates with nasopharyngeal teratomas and severe respiratory distress were reviewed.

RESULTS

The nasopharyngeal mass resulted in severe respiratory compromise requiring urgent intervention. Characteristic mandibular and pterygoid plate abnormalities demonstrated by CT and MRI are described.

CONCLUSIONS

Prenatal MRI enables the diagnosis, delineates tumour extent and allows planned delivery. CT and MRI play a key role in differentiating neonatal nasopharyngeal teratomas from other causes of a neonatal neck mass, thus optimising management.

Epignathus teratoma: report of three cases with a review of the literature

Three cases of epignathus teratoma associated with other midline anomalies are reported. The first case involved Pierre Robin sequence and a bifid tongue. The second case was characterized by two teratomas, a meningoencephalocele, and a cleft lip and nose. The third case had Pierre Robin sequence associated with duplication of the pituitary gland and hypoplasia of the corpus callosum.

Nasopharyngeal teratoma and mosaic tetrasomy 1q detected at amniocentesis. A case report and review of the literature

The occurrence of nasopharyngeal teratomas (NPT) is an infrequent event and prenatal detection of such tumors is even rarer. We present a case report and review of the literature (N = 78 cases), in which we describe the cytogenetic, DNA, and pathological findings of a fetus with a mature NPT which was detected prenatally by ultrasound investigation following complaints of severe polyhydramnios by the mother.

Teratoma in a newborn: an unusual cause of airway obstruction

We report the case of a newborn girl who presented with an inspiratory stridor and apneic episodes due to a mass in the oropharynx. On flexible pharyngo-laryngoscopy, it appeared that on inspiration this swelling, originating from the oropharynx, was sucked into the larynx, obstructing the airway. After intubation under flexible optic control the swelling was excised using the CO2-laser. Histopathological examination showed a teratoma of the oropharynx. The postoperative course was uneventful. Teratomas of the oropharynx are rare and are treated by surgical excision. If respiratory distress accompanies the lesion, priority must be given to securing the airway.

Primary and secondary orbital teratomas

Two patients with primary teratomas of the orbit and a third patient with a teratoma invading the orbit from the maxillary sinus are presented. The clinical presentation of each patient was spectacular. In the primary teratomas, the globe was displaced out of the orbit by the attached tumor, causing extreme proptosis. Computed tomography was virtually diagnostic, showing a variegated orbital mass with solid and cystic components. Histologic examination showed multiple tissues derived from two or three germinal layers. The surgical removal of the tumors and reasons for the poor visual outcome are discussed. The appearance of teratomas in the orbit and other cephalic structures appears to arise from the survival and proliferation of germ cells deposited there during embryogenesis.

Nasopharyngeal teratoma in the neonate

Nasopharyngeal teratomas are rare neoplasms, often presenting as neonatal airway obstruction. A case is presented of a full-term neonate with a mass which filled the oropharynx, nasopharynx and the entire left nasal cavity and extended through the left nares. Airway obstruction necessitated orotracheal intubation immediately after delivery. Cerebrospinal fluid rhinorrhea was suggested and computerized tomography was initially interpreted as a nasoethmoidal encephalocele. After a craniotomy failed to reveal a dural defect, the mass was completely removed via the nose and nasopharynx. The infant was extubated and had an uneventful recovery. This case illustrates the problem of confusing a teratoma for an encephalocele and demonstrates a pitfall in the interpretation of computerized tomography of these lesions.