1
|
Tsoutsanis PA, Charonis GC. Congenital orbital teratoma: a case report with preservation of the globe and 18 years of follow-up. BMC Ophthalmol 2021; 21:456. [PMID: 34963454 PMCID: PMC8715611 DOI: 10.1186/s12886-021-02229-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 12/23/2021] [Indexed: 11/10/2022] Open
Abstract
Background Congenital orbital teratomas are extremely rare, usually benign neoplasms, comprised of cells originating from all three germ cell layers. Clinically the tumor appears solid, most of the times is intraconal and presents as a rapidly growing mass leading to a massive unilateral axial proptosis, chemosis, exposure keratopathy, markedly distended eyelids and often, loss of vision. To prevent these complications, tumor excision usually involves enucleation or even orbital exenteration. Case presentation We report a case of a 1-day old infant who presented with dramatic proptosis at birth due to a true congenital orbital teratoma. We describe the clinical findings, the preoperative neuroimaging, the surgical management which included complete tumor resection with preservation of the globe to allow for optimal orbital growth, the histopathological evaluation, and the clinical course during 18 years of follow up. Conclusion Every effort to salvage the globe should be made to achieve the best possible orbito-facial development. Furthermore, the value of prompt surgical management with a less invasive transconjunctival globe sparing procedure can be appreciated in our case.
Collapse
|
2
|
Yang Z, Du L, Zhang H. Congenital orbital teratoma: A clinicopathologic case report. J Obstet Gynaecol Res 2021; 47:2225-2229. [PMID: 33719103 DOI: 10.1111/jog.14744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/30/2021] [Accepted: 02/28/2021] [Indexed: 11/30/2022]
Abstract
Here we report an extremely rare case of immature congenital orbital teratoma. The ultrasound scan at the 28+1 week of gestation revealed a massive, solid, and cystic mass in the left orbital region of the fetus. The lesion site was confirmed by magnetic resonance imaging. Based on clinical examination and imaging, the diagnosis of orbital teratoma without intracranial extension was made. Histopathological examination further confirmed the diagnosis of immature teratoma. The clinical course, radiographic, and histopathological findings of this disease were also summarized.
Collapse
Affiliation(s)
- Zhifen Yang
- Department of Obstetrics and Gynecology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Lijia Du
- Department of Obstetrics and Gynecology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Huixin Zhang
- Department of Obstetrics and Gynecology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| |
Collapse
|
3
|
Chen X, Yang J, He G, Cheng C, Zhang C, Wang H, He L, Yang Z, Chen L, Zhao J. Orbital teratoma in the foetus: a rare case without proptosis. BMC Ophthalmol 2020; 20:415. [PMID: 33076862 PMCID: PMC7574247 DOI: 10.1186/s12886-020-01681-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 10/05/2020] [Indexed: 11/15/2022] Open
Abstract
Background Congenital orbital teratoma is relatively rare, and few reports of prenatal ultrasound findings in such cases have been published. Case presentation A rare case of congenital orbital teratoma at 24 + 2 weeks of gestation was previously diagnosed as microphthalmia, noting how orbital teratoma without proptosis is different from microphthalmia, retinoblastoma and intracranial teratoma. Ultrasound examination, analysis of gross specimens, and histopathological evaluation confirmed the diagnosis of orbital teratoma. Conclusion Prenatal ultrasound examination is useful for diagnosis and differential diagnosis of congenital orbital teratoma.
Collapse
Affiliation(s)
- Xi Chen
- Department of Ultrasound, Sichuan Provincial Hospital for Women and Children, No.290 Sha Yan Xi Er Street, Chengdu City, Sichuan Province, China
| | - Jiaxiang Yang
- Department of Ultrasound, Sichuan Provincial Hospital for Women and Children, No.290 Sha Yan Xi Er Street, Chengdu City, Sichuan Province, China
| | - Guannan He
- Department of Ultrasound, Sichuan Provincial Hospital for Women and Children, No.290 Sha Yan Xi Er Street, Chengdu City, Sichuan Province, China
| | - Chunlan Cheng
- Department of Clinical Laboratory, Sichuan Provincial Hospital for Women and Children, Chengdu, Sichuan, China
| | - Chunguo Zhang
- Department of Ultrasound, Sichuan Provincial Hospital for Women and Children, No.290 Sha Yan Xi Er Street, Chengdu City, Sichuan Province, China
| | - Hongli Wang
- Department of Ultrasound, Sichuan Provincial Hospital for Women and Children, No.290 Sha Yan Xi Er Street, Chengdu City, Sichuan Province, China
| | - Lihong He
- Department of Ultrasound, Sichuan Provincial Hospital for Women and Children, No.290 Sha Yan Xi Er Street, Chengdu City, Sichuan Province, China
| | - Zhirong Yang
- Department of Pathology, Sichuan Provincial Hospital for Women and Children, Chengdu, Sichuan, China
| | - Li Chen
- Department of Pathology, People's Hospital of DeYang City, DeYang City, Sichuan, China
| | - Jing Zhao
- Department of Ultrasound, Sichuan Provincial Hospital for Women and Children, No.290 Sha Yan Xi Er Street, Chengdu City, Sichuan Province, China.
| |
Collapse
|
4
|
Peiró JL, Sbragia L, Scorletti F, Lim FY, Shaaban A. Management of fetal teratomas. Pediatr Surg Int 2016; 32:635-47. [PMID: 27112491 DOI: 10.1007/s00383-016-3892-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/31/2016] [Indexed: 10/21/2022]
Abstract
Fetal teratomas are the most common tumors diagnosed prenatally. The majority of these tumors are benign and cured by complete resection of the mass during the neonatal period. Prenatal diagnosis has improved the perinatal management of these lesions and especially for the teratomas that might benefit from fetal intervention. A comprehensive prenatal evaluation including conventional ultrasounds, Doppler, echocardiography and fetal MRI, is essential for an effective counseling and perinatal management. Antenatal counseling helps the parents to better understand the natural history, fetal intervention, and perinatal management of these tumors, which differ dramatically depending on their size and location. Fetal surgical debulking improves survival in cases of sacrococcygeal teratoma with cardiac decompensation. Additionally, the use of an EXIT procedure reduces the morbidity and mortality if a complicated delivery in cases of cervical and mediastinal teratomas. Here, we offer an overview of all fetal teratomas and their recommended management, with emphasis on in utero treatment options.
Collapse
Affiliation(s)
- Jose L Peiró
- Cincinnati Fetal Center, Pediatric General and Thoracic Surgery Division, Cincinnati Children's Hospital Medical Center (CCHMC), University of Cincinnati, 3333 Burnet Avenue, MLC 11025, Cincinnati, OH, 45229-3039, USA.
| | - Lourenço Sbragia
- Cincinnati Fetal Center, Pediatric General and Thoracic Surgery Division, Cincinnati Children's Hospital Medical Center (CCHMC), University of Cincinnati, 3333 Burnet Avenue, MLC 11025, Cincinnati, OH, 45229-3039, USA
| | - Federico Scorletti
- Cincinnati Fetal Center, Pediatric General and Thoracic Surgery Division, Cincinnati Children's Hospital Medical Center (CCHMC), University of Cincinnati, 3333 Burnet Avenue, MLC 11025, Cincinnati, OH, 45229-3039, USA
| | - Foong Y Lim
- Cincinnati Fetal Center, Pediatric General and Thoracic Surgery Division, Cincinnati Children's Hospital Medical Center (CCHMC), University of Cincinnati, 3333 Burnet Avenue, MLC 11025, Cincinnati, OH, 45229-3039, USA
| | - Aimen Shaaban
- Cincinnati Fetal Center, Pediatric General and Thoracic Surgery Division, Cincinnati Children's Hospital Medical Center (CCHMC), University of Cincinnati, 3333 Burnet Avenue, MLC 11025, Cincinnati, OH, 45229-3039, USA
| |
Collapse
|
5
|
Yan J, Li Y, Chen Q, Ye X, Li J. Rare orbital cystic lesions in children. J Craniomaxillofac Surg 2015; 43:238-43. [DOI: 10.1016/j.jcms.2014.11.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 10/22/2014] [Accepted: 11/13/2014] [Indexed: 10/24/2022] Open
|
6
|
Erickson BP, Tse DT. Management of neonatal proptosis: a systematic review. Surv Ophthalmol 2013; 59:378-92. [PMID: 24929905 DOI: 10.1016/j.survophthal.2013.11.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 11/04/2013] [Accepted: 11/12/2013] [Indexed: 11/30/2022]
Abstract
Gross proptosis presenting at birth is an uncommon manifestation of a variety of lesions that can compromise vision and result in disfigurement or even loss of life. Notably, many disease entities have different presentations and prognoses in neonates compared to older children. A structured mental framework is essential to an efficient and coordinated response. We present three challenging cases of neonatal proptosis and discuss the clinical presentation and biological behavior of the lesions that are most often implicated.
Collapse
Affiliation(s)
| | - David T Tse
- Bascom Palmer Eye Institute, Miami, Florida, United States.
| |
Collapse
|
7
|
Anami A, Fukushima K, Fujita Y, Satoh S, Matsumoto E, Endo M, Oda Y, Wake N. Antenatally diagnosed congenital orbital teratoma in which rupture was associated with intrauterine fetal death. J Obstet Gynaecol Res 2012; 38:578-81. [PMID: 22381109 DOI: 10.1111/j.1447-0756.2011.01738.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We report a case of a fetus with a congenital orbital teratoma (COT), in which rupture of the tumor was associated with an intrauterine fetal demise. An ultrasound scan at 27 weeks' revealed a solid and cystic, complex mass in the orbital region with extensive vascularization suggestive of an orbital cystic teratoma. Magnetic resonance imaging (MRI) supported this diagnosis and clarified tumor localization. At 32 weeks', the patient presented with fetal demise and rupture of the mass was noted. Fetal COTs, like sacrococcygeal teratomas, carry the risk of rupture. MRI in utero is useful for evaluating the extent of disease.
Collapse
Affiliation(s)
- Ai Anami
- Department of Obstetrics and Gynecology, Kyushu University Hospital, Kyushu University, Fukuoka, Japan
| | | | | | | | | | | | | | | |
Collapse
|
8
|
Polito E, Pichierri P, Trivella F, Martone G, Occhini R. Orbital teratoma masquerading as lymphangioma. J AAPOS 2011; 15:381-3. [PMID: 21907123 DOI: 10.1016/j.jaapos.2011.03.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2010] [Revised: 02/15/2011] [Accepted: 03/02/2011] [Indexed: 10/17/2022]
Abstract
Orbital teratoma in a newborn produces rapid and unilateral proptosis, which, combined with poor eyelid closure, may lead to corneal exposure and vision loss. Early surgical excision of the mass is recommended to preserve visual function. We report a case of an orbital teratoma masquerading as a lymphangioma in 6-month-old girl. The lesion was entirely excised using a transconjunctival approach with good cosmetic and functional results.
Collapse
Affiliation(s)
- Ennio Polito
- Department of Ophthalmology, University of Siena, Italy
| | | | | | | | | |
Collapse
|