Congenital Giant Teratoma Arising from the Hard Palate: A Rare Clinical Presentation

Surgical management of palatal teratoma (epignathus) with the use of virtual reconstruction and 3D models: a case report and literature review

Epignathus is a rare congenital orofacial teratoma that arises from the sphenoid region of the palate or the pharynx. It occurs in approximately 1:35,000 to 1:200,000 live births representing 2% to 9% of all teratomas. We present the case of a newborn of 39.4 weeks of gestation with a tumor that occupied the entire oral cavity. The patient was delivered by cesarean section. Oral resection was managed by pediatric surgery. Plastic surgery used virtual 3-dimensional models to establish the extension, and depth of the tumor. Bloc resection and reconstruction of the epignathus were performed. The mass was diagnosed as a mature teratoma associated with cleft lip and palate, nasoethmoidal meningocele that conditions hypertelorism, and a pseudomacrostoma. Tridimensional technology was applied to plan the surgical intervention. It contributed to a better understanding of the relationships between the tumor and the adjacent structures. This optimized the surgical approach and outcome.

A Case Report of a Massive Epignathus

Epignathus is a rare congenital orofacial teratoma. Teratomas are tumors that originate from all three germs cell layers. Tumor size is an important prognostic factor, and we describe the case of massive epignathus identified by sonography at 25 weeks. Our case was a 35-year-old pregnant woman that was subjected to a routine ultrasound at 25 weeks of gestation, and epignathus was diagnosed. Labor pain started in the 28th week of the pregnancy, so the dead fetus was aborted, and curettage was conducted. A pathologic sample was sent to the laboratory, and benign teratoma was diagnosed. Because fetal epignathus has a wide range of outcomes, early prenatal diagnosis is essential for optimal management.

Oral Epignathus with Maxilla Duplication: Report of a Rare Case

Epignathus is a rare congenital oropharyngeal teratoma that arises from the oropharynx, especially the sphenoid, palatine, and ethmoid bones. Teratomas are benign tumors containing cells from ectodermal, mesodermal, and endodermal layers. The incidence of epignathus is between 1:35,000 and 1:200,000 live births with a female predominance. We reported an uncommon case of epignathus in a female newborn baby with an ill-defined oral mass protruding through a cleft in the hard palate. Computed tomography scan showed a contrast-enhanced solid mass with areas of calcification simulating a unique case of maxilla duplication. Surgery was performed, the mass was excised successfully, and microscopic analysis confirmed the diagnosis of mature teratoma. The patient evolved with good general health and showed no clinical signs of recurrence. Although epignathus is a rare condition, it should be diagnosed in the fetus as early as possible, especially to avoid fatal airway obstruction. In such cases, the treatment option is exclusively surgical, and complete resection is curative in most cases during the early neonatal period.

Oral Mass of a Fetus Incidentally Found during Second Trimester: Ultrasound Survey and Postnatal Prognosis of the Baby

Ultrasound (USG) and magnetic resonance imaging (MRI) can be used to detect and evaluate the face and neck tumors during the in-utero period. We reported and discussed an oral mass which was diagnosed incidentally at mid-trimester exam and managed successfully.