Rohaert Celine, Poleij Anne, Quispel Chantal, de Jong Miranda, Ciet Pierluigi, Cassel Florian
Division of Neonatalogy, Department of Neonatal and Pediatric Intensive Care, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.
Department of Obstetrics and Gynecology, Albert Schweitzer Hospital, Dordrecht, The Netherlands.
Case Rep Perinat Med. 2023 Aug 14;12(1):20230009. doi: 10.1515/crpm-2023-0009. eCollection 2023 Jan.
Birth-related mechanical trauma to the newborn is an important issue and may be underestimated [Chaturvedi A, Chaturvedi A, Stanescu AL, Blickman JG, Meyers SP. Mechanical birth-related trauma to the neonate: an imaging perspective. Insights Imag 2018;9:103-18]. Risk factors for birth-related injuries include vacuum or forceps delivery, large size for gestational age and abnormal presentation before delivery [Gupta R, Cabacungan ET. Neonatal birth trauma: analysis of yearly trends, risk factors, and outcomes. J Pediatr 2021;238:174-80]. When a newborn has a soft tissue mass, there is a wide range of potential diagnoses, ranging from benign traumatic origins to aggressive phenotypes of malignant tumors [Thacker M. Benign soft tissue tumors in children. Orthop Clin N Am 2014;44:433-44]. Diagnosing a congenital tumor in a newborn creates uncertainty for parents and health care providers. Accurate imaging is crucial for distinguishing soft tissue mass origins.
A 32 weeks 6 days pregnant Caucasian woman was admitted after premature prelabor rupture of membranes (PPROM). Fetal ultrasound showed no abnormalities, the infant was born by a caesarean section. The delivery was complicated by the infant's transverse position. A female infant was born with a large left-sided dorsal soft tissue mass at the thoracic level with elastic consistency, and multiple skin lacerations. A broad differential diagnosis was made. Additional imaging was suggestive for a posttraumatic swelling due to transverse position during birth. The mass decreased and disappeared over three days.
The diagnosis of a soft tissue mass in a newborn can be challenging. A birth-related trauma affecting the soft tissue should be considered, especially if prenatal ultrasound findings were normal. Malpresentation during birth is a significant risk factor. Accurate diagnostic imaging is important to do before conducting further diagnostic examinations. The time course of the mass, before and after birth, can aid in determining its origin.
新生儿出生相关的机械性创伤是一个重要问题，可能被低估了[查图尔维迪A，查图尔维迪A，斯塔内斯库AL，布利克曼JG，迈尔斯SP。新生儿出生相关的机械性创伤：影像学视角。《洞察影像学》2018年；9：103 - 18]。出生相关损伤的危险因素包括真空吸引或产钳助产、大于胎龄儿以及分娩前胎位异常[古普塔R，卡巴昆甘ET。新生儿出生创伤：年度趋势、危险因素及结局分析。《儿科学杂志》2021年；238：174 - 80]。当新生儿出现软组织肿块时，潜在诊断范围广泛，从良性创伤性起源到恶性肿瘤的侵袭性表型[萨克M。儿童良性软组织肿瘤。《北美矫形外科学临床杂志》2014年；44：433 - 44]。诊断新生儿先天性肿瘤会给家长和医护人员带来不确定性。准确的影像学检查对于区分软组织肿块的起源至关重要。
一名怀孕32周6天的白人女性在胎膜早破（PPROM）后入院。胎儿超声检查未见异常，婴儿通过剖宫产出生。分娩因婴儿横位而复杂化。一名女婴出生时左侧胸段有一个大的背部软组织肿块，质地有弹性，并有多处皮肤裂伤。进行了广泛的鉴别诊断。进一步的影像学检查提示为出生时横位导致的创伤后肿胀。肿块在三天内缩小并消失。
诊断新生儿软组织肿块可能具有挑战性。应考虑与出生相关的软组织创伤，特别是产前超声检查结果正常时。出生时胎位异常是一个重要的危险因素。在进行进一步诊断检查之前，准确的诊断性影像学检查很重要。肿块在出生前后的变化过程有助于确定其起源。
