Giant congenital cervical Teratoma: A case report

Introduction: Congenital teratomas affecting the head and neck region are rare, accounting for only 2–5% of all germ cell tumors. Congenital cervical teratomas occur in 1 per 20,000 to 40,000 live births. Due to their location, giant neck teratomas obstruct the airway and esophagus, leading to polyh...

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Main Authors: Jennifer Milsten, Selin A. Weitkamp, Alexander G. Aghte, Joern-Hendrik Weitkamp
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Journal of Pediatric Surgery Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2213576624001660
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author Jennifer Milsten
Selin A. Weitkamp
Alexander G. Aghte
Joern-Hendrik Weitkamp
author_facet Jennifer Milsten
Selin A. Weitkamp
Alexander G. Aghte
Joern-Hendrik Weitkamp
author_sort Jennifer Milsten
collection DOAJ
description Introduction: Congenital teratomas affecting the head and neck region are rare, accounting for only 2–5% of all germ cell tumors. Congenital cervical teratomas occur in 1 per 20,000 to 40,000 live births. Due to their location, giant neck teratomas obstruct the airway and esophagus, leading to polyhydramnios and requiring an ex-utero intrapartum therapy (EXIT) procedure to allow survival. Case presentation: A large fetal neck mass resulting in fetal neck extension and polyhydramnios was noted at 24 weeks' gestation by ultrasound and further characterized by fetal MRI. The infant was delivered by classical c-section for non-reassuring fetal heart rate status at 33 weeks’ gestational age. The mass was overlying both mandibles, extending down the neck, leading to extensive neck extension and obscuring anatomic landmarks. Resuscitation required puncturing vocal cord adhesions with a rigid bronchoscope and suctioning of airway fluid prior to intubation. The extensively vascularized mass was successfully resected at one week of age, when it weighed 1088 g and was 21cm × 12cm x 8 cm in dimension. Pathology was consistent with a grade 3, stage II mixed immature and mature teratoma including tissue derivatives of three germ layers. Conclusion: Despite the unusually large size of this giant congenital neck teratoma, management by a multidisciplinary team with prenatal planning of resuscitation and postnatal treatment allowed for a positive outcome for the infant.
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spelling doaj-art-d439cdf17c9b43bc81b31fdf7582a4dd2025-08-20T02:39:09ZengElsevierJournal of Pediatric Surgery Case Reports2213-57662025-01-0111210293810.1016/j.epsc.2024.102938Giant congenital cervical Teratoma: A case reportJennifer Milsten0Selin A. Weitkamp1Alexander G. Aghte2Joern-Hendrik Weitkamp3Department of Pediatrics, Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University Medical Center, Nashville, TN, USADepartment of Internal Medicine, Vanderbilt University Medical Center, Nashville, TN, USADepartment of Pediatrics, Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University Medical Center, Nashville, TN, USADepartment of Pediatrics, Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University Medical Center, Nashville, TN, USA; Corresponding author.Introduction: Congenital teratomas affecting the head and neck region are rare, accounting for only 2–5% of all germ cell tumors. Congenital cervical teratomas occur in 1 per 20,000 to 40,000 live births. Due to their location, giant neck teratomas obstruct the airway and esophagus, leading to polyhydramnios and requiring an ex-utero intrapartum therapy (EXIT) procedure to allow survival. Case presentation: A large fetal neck mass resulting in fetal neck extension and polyhydramnios was noted at 24 weeks' gestation by ultrasound and further characterized by fetal MRI. The infant was delivered by classical c-section for non-reassuring fetal heart rate status at 33 weeks’ gestational age. The mass was overlying both mandibles, extending down the neck, leading to extensive neck extension and obscuring anatomic landmarks. Resuscitation required puncturing vocal cord adhesions with a rigid bronchoscope and suctioning of airway fluid prior to intubation. The extensively vascularized mass was successfully resected at one week of age, when it weighed 1088 g and was 21cm × 12cm x 8 cm in dimension. Pathology was consistent with a grade 3, stage II mixed immature and mature teratoma including tissue derivatives of three germ layers. Conclusion: Despite the unusually large size of this giant congenital neck teratoma, management by a multidisciplinary team with prenatal planning of resuscitation and postnatal treatment allowed for a positive outcome for the infant.http://www.sciencedirect.com/science/article/pii/S2213576624001660NewbornTeratomaCase report
spellingShingle Jennifer Milsten
Selin A. Weitkamp
Alexander G. Aghte
Joern-Hendrik Weitkamp
Giant congenital cervical Teratoma: A case report
Journal of Pediatric Surgery Case Reports
Newborn
Teratoma
Case report
title Giant congenital cervical Teratoma: A case report
title_full Giant congenital cervical Teratoma: A case report
title_fullStr Giant congenital cervical Teratoma: A case report
title_full_unstemmed Giant congenital cervical Teratoma: A case report
title_short Giant congenital cervical Teratoma: A case report
title_sort giant congenital cervical teratoma a case report
topic Newborn
Teratoma
Case report
url http://www.sciencedirect.com/science/article/pii/S2213576624001660
work_keys_str_mv AT jennifermilsten giantcongenitalcervicalteratomaacasereport
AT selinaweitkamp giantcongenitalcervicalteratomaacasereport
AT alexandergaghte giantcongenitalcervicalteratomaacasereport
AT joernhendrikweitkamp giantcongenitalcervicalteratomaacasereport