Huge congenital cervical immature teratoma mimicking lymphatic malformation in a 7-day-old male neonate

A Case of Cervical Teratoma in an Infant

Cervical teratoma is a rare form of teratoma in neonates and is an unusual cause of cervical masses in them. Teratomas are unusual tumors derived from all 3 germs cell layers: endoderm, mesoderm, and ectoderm, with varying proportions. The cervical teratoma is a rare entity. Its prognosis mostly depends on the risk of neonatal respiratory distress, its extension and potential malignancy. Surgical management must be as complete as possible to avoid recurrences and malignant transformation. We report a case of a cervical immature teratoma in an infant with total excision and cure. No recurrence has been reported. The aim of our study is to review the diagnosis, management and outcomes of congenital cervical teratomas. Cervical teratoma although uncommon should be considered in the differential diagnosis of neck masses in neonates. Teratomas are rare tumors derived from all three germ cell layers affecting the neck in 3% of all cases. An early complete surgical approach to congenital cervical teratomas allows good results with low rates of complication and recurrence.

Superior Vena Cava Syndrome and Hypoxic Ischemic Encephalopathy Secondary to a Massive, Right-Sided Immature Cervical Teratoma

Cervical teratomas are a rare form of fetal teratoma that can grow to massive size. Generally, these masses can be surgically excised after birth with excellent physical and functional prognosis because the benign variants respect anatomical borders. The primary complications of these masses are associated with compromise of the trachea and esophagus: upper airway obstruction and polyhydramnios. We report the first documented occurrence of superior vena cava syndrome and hypoxic ischemic encephalopathy associated with a massive, right-sided cervical teratoma. This case highlights that when cervical teratomas are right-sided and sufficiently large, they can extend inferiorly and compromise central venous return to the heart. This unique presentation would likely have required fetal surgical excision to avoid catastrophic cerebral injury.

Cervical Giant Immature Teratoma in a Newborn: A Challenge for Survival

Teratomas are a conglomerate of heterogenous cells arising from totipotent germ cells. Cervical teratomas occur 1 per 20,000 to 40,000 live births constituting 1.6-9.3% of all paediatric teratomas. They can present antenatally with cervical mass or polyhydramnios and postnatally with respiratory distress and facial disfigurement. Complete excision of the tumour prevents malignant transformation. Timing of the surgery is based on severity of airway compromise. Surgical outcome and survival depend on pre-existing pressure effects, operative injuries to the vital structures and also co-existing comorbidities. One such complicated case of giant cervical teratoma is described here.