1
|
Tavares de Sousa M, Chaoui R, Herrmann J, Hecher K. Intrauterine laser coagulation of rapidly growing epignathus with autonomous cardiac activity. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2024; 63:419-420. [PMID: 37676230 DOI: 10.1002/uog.27477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 09/08/2023]
Affiliation(s)
- M Tavares de Sousa
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - R Chaoui
- Center for Prenatal Diagnosis and Human Genetics, Berlin, Germany
| | - J Herrmann
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Section of Pediatric Radiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - K Hecher
- Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
2
|
Li YL, Zhen L, Li DZ. Prenatal Diagnosis of Oral Teratoma by Ultrasound. J Med Ultrasound 2024; 32:76-78. [PMID: 38665348 PMCID: PMC11040491 DOI: 10.4103/jmu.jmu_47_22] [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: 05/17/2022] [Revised: 07/03/2022] [Accepted: 08/30/2022] [Indexed: 11/05/2022] Open
Abstract
A pregnant woman had a normal second-trimester anatomic survey at 22 weeks gestation. She was revealed to have a fetal oral mass with polyhydramnios and invisible stomach bubble by ultrasound at 28 weeks. A 50 mm × 36 mm × 42 mm, solid mass was found in the fetal mouth, filling the entire oral cavity. Fetal magnetic resonance imaging showed a homogeneous solid mass in the oral cavity compressing the hypopharynx. At 33 weeks, preterm labor occurred because of the continuation of increased amniotic fluid volume, and a female infant was vaginally delivered. The infant died shortly after tracheal intubation attempt failed. Autopsy confirmed the prenatal sonographic finding. The final pathologic diagnosis was oral immature teratoma. Our study indicates that although oral teratomas are rare, they are readily apparent at prenatal sonographic examinations. Respiratory compromise is the frequent complication of oral teratomas, which is associated with high perinatal mortality.
Collapse
Affiliation(s)
- Yan-Lin Li
- Prenatal Diagnostic Center, Guangzhou Women and Children’s Medical Center, Guangzhou, Guangdong, China
| | - Li Zhen
- Prenatal Diagnostic Center, Guangzhou Women and Children’s Medical Center, Guangzhou, Guangdong, China
| | - Dong-Zhi Li
- Prenatal Diagnostic Center, Guangzhou Women and Children’s Medical Center, Guangzhou, Guangdong, China
| |
Collapse
|
3
|
Goto S, Nakazawa A, Yoshizawa T, Aoki M, Hirabayashi T, Seino H, Morohashi S, Kijima H. Case Report: A Giant Epignathus with a Well-Developed Skeleton of Head and Neck. Int J Surg Pathol 2023; 31:1335-1339. [PMID: 36412010 DOI: 10.1177/10668969221133739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
Epignathus is an extremely rare teratoma found in the oral cavity or oropharyngeal region of newborns, whose pathogenesis is poorly understood. We describe a giant epignathus arising from the oropharynx in a newborn. The giant tumor completely obstructed the airway of the newborn resulting in death. Histological and radiological examination of the tumor reveals the presence of a remarkably well-developed skeleton of the head and neck. A row of teeth, the axis and atlas, thyroid and salivary glands, trachea, and cerebral tissue are all detected within the tumor. These findings suggest that the epignathus is fetus-in-fetu which is considered a type 0 germ cell tumor in accordance with current literature.
Collapse
Affiliation(s)
- Shintaro Goto
- Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Atsuko Nakazawa
- Department of Clinical Research, Saitama Children's Medical Center, Saitama, Japan
| | - Tadashi Yoshizawa
- Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Masahiko Aoki
- Department of Radiation Oncology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Takeshi Hirabayashi
- Department of Pediatric Surgery, Hirosaki University Hospital, 53-Hon-cho, Hirosaki, Aomori, Japan
| | - Hiroko Seino
- Department of Radiology, Aomori, National Hospital, Namiokamegasawa, Aomori, Japan
| | - Satoko Morohashi
- Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Hiroshi Kijima
- Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| |
Collapse
|
4
|
Meneses-Parra AL, Tarazona-Bueno RE, Aragón-Mendoza RL, Altman-Restrepo M. Teratoma nasofaríngeo inmaduro con diagnóstico prenatal: reporte de un caso y revisión de la literatura. REVISTA COLOMBIANA DE OBSTETRICIA Y GINECOLOGÍA 2023; 74:68-86. [PMID: 37093940 PMCID: PMC10174717 DOI: 10.18597/rcog.3906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 01/16/2023] [Indexed: 03/30/2023]
Abstract
Objetivos: reportar el caso de una gestante con diagnóstico de feto con teratoma nasofaríngeo inmaduro y realizar una revisión describiendo el pronóstico de esta patología.
Materiales y métodos: se reporta el caso de una gestante de 27 años, atendida en la Unidad de Ginecología y Obstétrica de un centro de referencia en Bogotá (Colombia), por hallazgo durante el control prenatal de un feto con evidencia de polihidramnios secundario a teratoma nasofaríngeo. Se realizó una búsqueda bibliográfica en las bases de datos Medline vía PubMed, Scopus, SciELO y ScienceDirect, restringiendo tipo de idioma (inglés y español) y por fecha de publicación (enero de 2001 a enero de 2021). Se incluyeron reportes de caso y series de casos que abarcaran el pronóstico de esta patología.
Resultados: la búsqueda recuperó 168 títulos, de los cuales 55 cumplieron con los criterios de inclusión. En total se reportó el resultado perinatal de 58 fetos con diagnóstico de teratoma nasofaríngeo inmaduro detectado en etapa prenatal. En los casos identificados, la mortalidad perinatal fue del 25,4 % y el porcentaje de óbito fue cercano al 3,6 %.
Conclusiones: el teratoma nasofaríngeo inmaduro es una patología poco frecuente. La literatura disponible sugiere que el pronóstico fetal depende del grado de compromiso de las estructuras intracraneales y de la posibilidad de resección de la lesión. Se requieren más estudios que evalúen el pronóstico de los fetos con teratoma nasofaríngeo inmaduro.
Collapse
|
5
|
Runggaldier D, Reinehr M, Friedrich H, Henze G, Good D, Gysin C. Case report and review of the literature: rare fetus-in-fetu presenting as oropharyngeal epignathus. Front Surg 2023; 10:1122327. [PMID: 37206355 PMCID: PMC10191252 DOI: 10.3389/fsurg.2023.1122327] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 04/12/2023] [Indexed: 05/21/2023] Open
Abstract
An epignathus is caused by a continuous spectrum of masses of the oral cavity or oropharynx ranging in its entity from mature teratoma to the exceedingly rare fetus-in-fetu. Due to its location, regardless of the entity, the occurrence of an epignathus is frequently associated with life threatening airway obstruction. Here we demonstrate a case of a fetus-in-fetu presenting as an epignatus. We describe its successful management and review the available literature. Early diagnosis and knowledge of the preoperative workup are essential to enable a multidisciplinary management. Once the airway is secured, surgical excision is the treatment of choice often resulting in a good clinical outcome and prognosis.
Collapse
Affiliation(s)
- Daniel Runggaldier
- Division of Pediatric Otolaryngology, University Children's Hospital, Zurich, Switzerland
- Departmentof Otorhinolaryngology, Head & Neck Surgery, University Hospital Zürich, University of Zurich, Zürich, Switzerland
| | - Michael Reinehr
- Departmentof Otorhinolaryngology, Head & Neck Surgery, University Hospital Zürich, University of Zurich, Zürich, Switzerland
- Institute for Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Hergen Friedrich
- Division of Pediatric Otolaryngology, University Children's Hospital, Zurich, Switzerland
| | - Georg Henze
- Department of Anesthesia, University Children’s Hospital, Zürich, Switzerland
| | - Dominic Good
- Division of Pediatric Otolaryngology, University Children's Hospital, Zurich, Switzerland
| | - Claudine Gysin
- Division of Pediatric Otolaryngology, University Children's Hospital, Zurich, Switzerland
- Correspondence: Claudine Gysin
| |
Collapse
|
6
|
Surgical management of palatal teratoma (epignathus) with the use of virtual reconstruction and 3D models: a case report and literature review. Arch Plast Surg 2021; 48:518-523. [PMID: 34583437 PMCID: PMC8490109 DOI: 10.5999/aps.2021.00318] [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: 02/10/2021] [Accepted: 05/27/2021] [Indexed: 11/24/2022] Open
Abstract
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.
Collapse
|
7
|
Lele Mutombo F, Nzanzu Kikuhe J, Kasereka Mwanamolo N, Erickson MH, Wetzig N, Kabuyaya Kakule M. Congenital epignathus associated with a cleft palate: a case report. J Med Case Rep 2021; 15:422. [PMID: 34340710 PMCID: PMC8330006 DOI: 10.1186/s13256-021-03007-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 07/09/2021] [Indexed: 01/04/2023] Open
Abstract
Background Epignathus is a rare, benign, congenital teratoma of the hard palate with an estimated incidence of 1 in 200,000 live births. Epignathus frequently leads to a high mortality (80–100%) due to airway obstruction in the neonatal period. Case presentation We report a case of successful management of a rare oropharyngeal teratoma in a African newborn girl who was referred to our institute with a large protruding intraoral mass, combined with cleft palate, causing some respiratory compromise. The palatal mass was removed on the fifth day after birth, and a palatoplasty performed on day 30. Conclusion Epignathus is a life-threatening condition at the time of delivery. Appropriate management begins with securing the airway, followed by complete resection of the tumor.
Collapse
Affiliation(s)
| | - Jason Nzanzu Kikuhe
- ENT Department, GOMA Provincial Referral Hospital, Goma, Democratic Republic of Congo
| | | | - Marc H Erickson
- Surgery Department, Fort Memorial Hospital, Milwaukee, Wisconsin, USA
| | - Neil Wetzig
- Surgery Department, Heal Africa Hospital, Goma, Democratic Republic of Congo
| | - Médard Kabuyaya Kakule
- Surgery Department, Heal Africa Hospital, Goma, Democratic Republic of Congo.,Faculty of Medicine, Surgery Department, University of Goma, Goma, Democratic Republic of Congo
| |
Collapse
|
8
|
Pellegrini V, Colasurdo F, Guerriero M. Epignathus with oropharynx destruction. AUTOPSY AND CASE REPORTS 2021; 11:e2021293. [PMID: 34249796 PMCID: PMC8232380 DOI: 10.4322/acr.2021.293] [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: 04/27/2021] [Accepted: 05/17/2021] [Indexed: 11/23/2022] Open
Abstract
Epignathus, is a rare oropharyngeal teratoma arising from the head and neck region. Sporadic cases have been described with associated intracerebral teratoma. Even more infrequent and extraordinary is the circumstance of a teratoma with oropharynx destruction. We describe the case of a fetus with pharyngeal mass that completely destroyed the oral cavity. The histological examination revealed an immature teratoma (G3); only one other G3 case has been described.
Collapse
Affiliation(s)
- Valerio Pellegrini
- Ospedale Antonio Cardarelli, Regional Health Authority of Molise, Medical Department, Campobasso, Italy
| | - Francesco Colasurdo
- Ospedale Antonio Cardarelli, Regional Health Authority of Molise, Analysis Department of Transmural Services, Campobasso, Italy
| | - Massimiliano Guerriero
- Ospedale Antonio Cardarelli, Regional Health Authority of Molise, Pathology Laboratory Department of Transmural Services, Campobasso, Italy
| |
Collapse
|
9
|
Rubio EI. Imaging of the fetal oral cavity, airway and neck. Pediatr Radiol 2021; 51:1122-1133. [PMID: 33978788 DOI: 10.1007/s00247-020-04851-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/12/2020] [Accepted: 09/09/2020] [Indexed: 11/30/2022]
Abstract
Magnetic resonance imaging has proved to be an extraordinarily useful adjunct modality in assessment of the fetal face, oral cavity, head and neck because of its soft-tissue contrast, utility for acquiring more precise planar imaging and the inherent advantage of contrast provided by fluid-filled structures, including the oropharyngeal cavity, nasal passages and vascular structures. In this review, the author presents an organized approach to assessing normal anatomical structures of the fetus. The author presents cystic and solid lesions as well as structural and developmental abnormalities and discusses potential concomitant abnormalities. Prenatal consultation, patient counseling and delivery considerations are included.
Collapse
Affiliation(s)
- Eva Ilse Rubio
- Division of Diagnostic Imaging and Radiology, Children's National Hospital, George Washington School of Medicine, 111 Michigan Ave. NW, Washington, DC, 20010, USA.
| |
Collapse
|
10
|
Saryeva OP, Zolotukhina AO, Protsenko EV, Sharygin SA. [Congenital immature teratomas. Two case reports]. Arkh Patol 2021; 83:33-37. [PMID: 33822552 DOI: 10.17116/patol20218302133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Teratomas belong to a group of germ cell tumors and consist of tissues that are derived from 3 germ layers. The localization of teratomas is extremely diverse. The main task of a morphological study is to diagnose the type of teratoma. According to the WHO classification, there are mature and immature teratomas (ICD-O codes 9080/0 and 9080/3, respectively). It is deemed that the disease prognosis does not depend on the composition of mature tissue components. This paper describes two sectional observations of congenital immature teratomas in a premature live birth infant and a stillborn one. One teratoma, such as epignathus, is a very rare tumor in localization. Emphasis is laid on the need for a thorough teratoma morphological study that defines the tactics of patient management. The described observations demonstrate the importance of timely prenatal diagnosis and an interdisciplinary approach, as well as the need for clear routing of patients with diagnosed fetal space-occupying lesions.
Collapse
Affiliation(s)
- O P Saryeva
- V.N. Gorodkov Ivanovo Research Institute of Maternity and Childhood of the Ministry of Health of Russia, Ivanovo, Russia
| | - A O Zolotukhina
- V.N. Gorodkov Ivanovo Research Institute of Maternity and Childhood of the Ministry of Health of Russia, Ivanovo, Russia
| | - E V Protsenko
- V.N. Gorodkov Ivanovo Research Institute of Maternity and Childhood of the Ministry of Health of Russia, Ivanovo, Russia
| | - S A Sharygin
- V.N. Gorodkov Ivanovo Research Institute of Maternity and Childhood of the Ministry of Health of Russia, Ivanovo, Russia
| |
Collapse
|
11
|
Simonini C, Strizek B, Berg C, Gembruch U, Mueller A, Heydweiller A, Geipel A. Fetal teratomas - A retrospective observational single-center study. Prenat Diagn 2020; 41:301-307. [PMID: 33242216 DOI: 10.1002/pd.5872] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/26/2020] [Accepted: 11/23/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Evaluation of course and outcome of pregnancies with prenatally diagnosed fetal teratomas of various locations in a single center between 2002 and 2019. METHODS Retrospective observational single-center study including prenatally suspected or diagnosed fetal teratomas. Focus was put on ultrasound findings during pregnancy. Complications, need for intervention and outcomes were compared according to tumor location. RESULTS 79 cases of fetal teratomas were seen at our center between 2002 and 2019. Most frequent tumor locations were the sacrococcygeal region (59.5%), neck (20.2%) and oropharynx (7.6%). Complications mainly included polyhydramnios and cardiac compromise. Need for intervention during pregnancy was significantly higher in pericardial teratomas. Preterm birth before 37 and early preterm birth before 32 weeks occurred in 72.7% and 29.1%, respectively. Major causes of perinatal death were tumor bleeding in sacrococcygeal teratomas (SCTs) and respiratory failure in cervical and oropharyngeal teratomas. CONCLUSION There is a high need for intervention in pregnancies complicated by fetal teratomas. Pericardiocentesis in pericardial teratomas is often inevitable to reduce the risk of intrauterine demise. Amniotic fluid drainage in associated severe polyhydramnios helps to reduce the risk of preterm birth, a major cause of additional morbidity and mortality. MRI in supplement to prenatal ultrasound is useful in fetal teratomas of the neck and oropharynx in order to plan delivery.
Collapse
Affiliation(s)
- Corinna Simonini
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Bonn, Germany
| | - Brigitte Strizek
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Bonn, Germany
| | - Christoph Berg
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Bonn, Germany
| | - Ulrich Gembruch
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Bonn, Germany
| | - Andreas Mueller
- Department of Neonatology and Pediatric Intensive Care, University Hospital Bonn, Bonn, Germany
| | | | - Annegret Geipel
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Bonn, Germany
| |
Collapse
|