Epignathus Leading to Fatal Airway Obstruction in a Neonate

Teratomas are benign tumours containing cells from ectodermal, mesodermal and endodermal layers with an incidence of about 1 in every 4,000 births. Their commonest site is sacro-coccygeal region, followed by anterior mediastinum. The incidence of teratomas localised to the head and neck region is around 2-9% of all cases. Epignathus is a rare congenital oropharyngeal teratoma originating from the base of the skull. Here we present a rare case of oropharyngeal teratoma in a neonate who was referred to our institute with an ill-defined oral mass protruding through a cleft in the hard palate. Computed tomography scan showed a contrast-enhanced solid mass with areas of calcification and fat extending to oropharynx and nasal cavity with hard palate defect suggestive of a teratoma. Unfortunately, the patient succumbed due to respiratory compromise before the biopsy could be done. Postmortem histopathological examination confirmed diagnosis of benign teratoma consisting of mature tissue.