Prenatal diagnosis of epignathus with multiple malformations in one fetus of a twin pregnancy using three-dimensional ultrasonography and magnetic resonance imaging

Perinatal management for fetal oral epignathus with duplication of the pituitary gland (DPG)-plus syndrome: A case report and literature review

The prenatal diagnosis of epignathus presents a unique challenge for physicians. Differential diagnosis is usually based on the anatomic location of the tumor. Typical prenatal ultrasound characteristics of epignathus include a mixed solid and cystic lesion with vascularity in the solid component, originating from the hard or soft palate, and it is often associated with other anomalies such as craniofacial clefts or trans-sphenoidal intracranial extension. Herein, we present a case of prenatal diagnosis of epignathus with rare ultrasonographic findings, prenatal management requiring collaborative efforts of a multidisciplinary team, and a well-planned innovative ex utero intrapartum treatment procedure. In addition, this report highlights the evolving postnatal diagnosis of the rare developmental anomaly, duplication of the pituitary gland-plus syndrome, which includes various midline craniofacial, central nervous system, spinal, and endocrine abnormalities.

Teratoma nasofaríngeo inmaduro con diagnóstico prenatal: reporte de un caso y revisión de la literatura

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.

Giant Epignathus (Teratoma of Palatine Tonsil): A Case Report

Teratomas are benign tumours containing tissues derived from ectoderm, endoderm and mesoderm Epignathus is a rare congenital teratoma and originates from oropharyngeal region. We present a case of giant epignathus arising from tonsillar region in a neonate. A male neonate that was born with a 38-week cesarean section presented with a pedunculated mass from left tonsilla palatina and protruding outside the mouth. The patient did not have any airway problem. Magnetic resonance imaging and computed tomography scan showed no intracranial extension. The patient was operated on the postpartum 3rd day and the mass was excised successfully. After histopathological examination, mature teratoma was diagnosed. During post-operative 6 months control visit, there was no recurrence. Epignathus is a rare congenital oropharyngeal teratoma, it should be diagnosed in the fetus as early as possible. Teratomas of the tonsilla palatina are extremely rare. In such cases, the mass may cause airway obstruction and feeding difficulties so complete resection is curative in most cases during the early neonatal period.

Prenatal Diagnosis and Immediate Successful Management of Isolated Fetal Epignathus

Epignathus or enigmatic teratoma is rare congenital tumor, arising from the sphenoid region of the palate or pharynx. A 30-year-old pregnant woman presented at 34 weeks + 2 days’ gestation with a well-defined solid mass measuring 6.47 cm × 5.7 cm arising from the fetal oral cavity. The color flow mapping showed that the mass was well vascularized, especially in its center, and its blood supply was originated from the fetal oral cavity. The newborn has no chromosomal abnormalities or other associated anomalies and/or intracranial extension immediately and successfully managed after delivery to highlight the importance of prenatal diagnosis and the importance of multidisciplinary team management.

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.