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Massive lingual teratoma in a neonate
S Hassan1, D S Sidek, W D Shah Jihan
1Department of Otorhinolaryngology-Head & Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia. shahid@kb.usm.my
Singapore Medical Journal
|July 28, 2007
Summary
A rare lingual teratoma in a newborn, presenting as a massive oral cavity mass with cleft palate, was successfully excised. Despite its size, it surprisingly did not cause immediate airway obstruction, highlighting a unique case presentation.
Area of Science:
- Developmental Biology
- Pediatric Surgery
- Pathology
Background:
- Teratomas are germ cell tumors containing elements from all three embryonic germ layers.
- Lingual teratomas are exceptionally rare congenital anomalies, particularly in newborns.
- Congenital oral masses can pose significant challenges in neonatal airway management.
Observation:
- A male newborn presented with a massive lingual teratoma and cleft palate.
- The large oral mass did not cause immediate respiratory distress, contrary to expectations.
- Antenatal ultrasonography failed to detect the teratoma due to the absence of polyhydramnios.
Findings:
- Surgical excision of the lingual teratoma was performed under general anesthesia.
- Histopathological examination confirmed the teratoma comprised all three embryonic germ layers, with a predominance of glial tissue.
- Postoperative hypoglossal nerve palsy occurred, but no tumor recurrence was observed at four-year follow-up.
Implications:
- This case underscores the variability in presentation of congenital lingual teratomas.
- It highlights the importance of thorough postnatal examination for neonatal oral masses, even with unremarkable antenatal scans.
- Successful surgical management and long-term surveillance are crucial for pediatric teratoma cases.
