Surgical management of immature teratoma involving the oral cavity and orbit in a neonate

Congenital orbital teratoma: a case report with preservation of the globe and 18 years of follow-up

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.

Surgical Treatment of Massive Teratoma of the Orbit

Orbital location of teratoma is extremely rare. The differential diagnosis can be difficult and they may be mistaken for other tumors as they may have both cystic and solid areas. The authors report a case of a 7-day-old neonate with a massive congenital orbital teratoma in which it was decided to apply a surgical technique that involves the aspiration of the cystic fluid, the subsequent infusion of fibrin glue, and the radical excision. The definitive histological examination reported a diagnosis of trifillic cystic teratoma. At fourth year of follow up the patient is free from disease.

Congenital orbital teratoma: A clinicopathologic case report

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.

Extended Maxillotomy for Nasopharynx Access in Infantile Immature Teratoma

Infantile immature teratoma located in the nasopharynx is a rare congenital tumor that is not easily removed. Three surgeries and chemotherapy for recurrence of the tumor have been performed since a male infant with a nasopharyngeal mass was born at a gestational age of 35 weeks. Extended maxillotomy combining Le Fort I osteotomy with midline palatal split was performed at 2 years and 6 months of age. Residual tumor left in the intracranial region had not increased as of 4 years of age. Careful follow-up is needed until the patient reaches adulthood.

Orbital immature teratoma: A rare entity with diagnostic challenges

Childhood orbital teratomas are congenital lesions that presents most often at birth with progressive, severe unilateral proptosis. Due to the rarity of such tumors, the diagnosis is often missed with delay in the patient's management. We are presenting a unique case of an immature right orbital teratoma with extensive growth in a full-term newly born baby boy. In this case report, we provide description of the clinical findings, initial misdiagnosis and the eventual management with review of similar reported cases.

Sequence of Surgical Reconstruction in a Child With Cleft Lip and Palate Associated With Congenital Facial Teratomas

We describe a case of left homolateral complete cleft lip/palate associated with a congenital left maxillary teratoma and left orbital teratoma. The patient required step-by-step reconstruction that first included resection of the 2 teratomas in consideration of cleft lip repair, cleft palate repair, and correction of the left periorbital anomalies, which were performed later. After performing all the necessary procedures, complete resection of the tumors and correction of the anomalies associated with the lip, palate, and left orbit were achieved. The rare occurrence of this type of association and its devastating effect on a patient's growth, aesthetics, and function of craniofacial elements require careful surgical planning to enable restoration of the anatomy and proper functional development. At follow-up, the patient showed significant improvement in the functional and aesthetic aspects.