McMahon M J, Chescheir N C, Kuller J A, Wells S R, Wright L N, Nakayama D K
Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill School of Medicine, USA.
Obstet Gynecol. 1996 May;87(5 Pt 2):848-51.
Teratomas of the head and neck are rare and occur almost exclusively in neonates. Prenatal diagnosis of these tumors allows for a carefully planned delivery that maintains an open airway and potentially improves perinatal outcome. We report the perinatal management of a huge intrapharyngeal and intra-oral teratoma that had a broad connection to the base of the tongue.
An anterior neck mass (5 x 5 cm) in an otherwise normal-appearing fetus was detected at 19 weeks' gestation. The mass increased in size over the next 10 weeks to 8 x 6.8 x 4.3 cm. Marked fetal head deflexion was noted along with concomitant hydramnios. The mother had spontaneous rupture of membranes with preterm labor at 29 weeks' gestation. A 1860-g male neonate was delivered by classical cesarean delivery. A tracheostomy was performed in the delivery room for ventilation after the upper airway could not be accessed by bronchoscopy. Histologic examination after surgical excision confirmed a congenital teratoma with immature neuroectodermal tissue and alpha-fetoprotein-bearing endodermal sinus tumor components with exclusively polyvesicular vitelline characteristics. The origin of the pharyngeal mass was the base of the tongue.
The prenatal diagnosis of a pharyngeal teratoma should prompt a careful delivery plan to optimize perinatal outcome.
头颈部畸胎瘤罕见，几乎仅发生于新生儿。对这些肿瘤进行产前诊断有助于制定精心规划的分娩方案，以维持气道通畅并可能改善围产期结局。我们报告了一例巨大的咽内及口内畸胎瘤的围产期管理情况，该肿瘤与舌根有广泛连接。
在一名外观正常的胎儿妊娠19周时，检测到颈部前方有一肿块（5×5厘米）。在接下来的10周内，肿块增大至8×6.8×4.3厘米。观察到明显的胎儿头部屈曲，并伴有羊水过多。母亲在妊娠29周时胎膜自然破裂并早产。通过古典式剖宫产分娩出一名体重1860克的男婴。由于经支气管镜无法进入上气道，在产房进行了气管切开术以进行通气。手术切除后的组织学检查证实为先天性畸胎瘤，伴有未成熟的神经外胚层组织和含甲胎蛋白的内胚窦瘤成分，且仅具有多囊性卵黄囊特征。咽部肿块起源于舌根。
咽畸胎瘤的产前诊断应促使制定仔细的分娩计划，以优化围产期结局。
