Malignant epignathus teratoma

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Abstract

A baby boy who had a left facial mass detected on antenatal ultrasound was delivered by Caesarian section after foetal distress was detected. Imaging investigations by plain radiographs and MRI showed a large mass with calcifications, soft tissue, fat and fluid components. A total surgical excision was perfomed and histology examination showed teratoma with no malignant features. Two weeks postoperatively, there was rapid recurrence of the tumour with intracranial involvement and obstructive hydrocephalus shown on MRI. The tumour was inoperable at surgery and the baby subsequently died at 5 weeks of life. This case describes the clinical course and imaging features of a neonatal epignathus teratoma with malignant and aggressive features. © 2008 Biomedical Imaging and Intervention Journal. All rights reserved.

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  • Figure 5 MR images two weeks after removal of the teratoma: (a) T2 weighted (TR 4500, TE 94) in coronal plane; and (b) T1-weighted (TR 9.7, TE 4.1) contrast-enhanced sequence in sagittal plane, showing recurrence. Tumour is seen occupying the oral cavity with extension into the left temporal fossa (black arrow) and brain stem compression (white arrow). There is evidence of moderate hydrocephalus.
  • Figure 1 Photograph of the baby immediately after delivery showing a large left facial mass distorting the external facial anatomy with displacement of the nose and left eye.
  • Figure 2 Plain radiograph of the head showing a large soft tissue mass protruding from the anterior aspect of the face with calcifications within it. Note the under-developed left temporomandibular joint (black arrow).
  • Figure 3 MR images: (a) T2 weighted ( TR 4500, TE 94) sequence in coronal plane showing the external portion of the tumour consisting of lobulated well defined areas of fluid, solid tissue and fat, in keeping with teratoma. There is involvement of the left temporal lobe of the brain (red arrow); (b) T1 weighted (TR 9.7, TE 4.1) contrast enhanced sequence in sagittal plane. Internally, the tumour is occupying the oropharynx, nasopharynx and oral cavity, effacing normal anatomy (red arrows).
  • Figure 4 Histopathology of the tumour tissue consisting of a haphazard mixture of organoid mature tissue: (a) skin adnexal tissue (Haematoxylin-eosin (HE) stain, x 10); (b) adipose cells (black arrow) and cysts lined by stratified squamous epithelium (red arrow) (HE stain, x 4); (c) primitive neuroepithelial cells arranged as rosettes (red arrows) (HE stain, x20).

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CITATION STYLE

APA

Too, S. C., Sarji, S. A., Yik, Y. I., & Ramanujam, T. M. (2008). Malignant epignathus teratoma. Biomedical Imaging and Intervention Journal, 4(2). https://doi.org/10.2349/biij.4.2.e18

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