Nasopharyngeal teratoma in the neonate

Nasopharyngeal teratomas are rare neoplasms, often presenting as neonatal airway obstruction. A case is presented of a full-term neonate with a mass which filled the oropharynx, nasopharynx and the entire left nasal cavity and extended through the left nares. Airway obstruction necessitated orotracheal intubation immediately after delivery. Cerebrospinal fluid rhinorrhea was suggested and computerized tomography was initially interpreted as a nasoethmoidal encephalocele. After a craniotomy failed to reveal a dural defect, the mass was completely removed via the nose and nasopharynx. The infant was extubated and had an uneventful recovery. This case illustrates the problem of confusing a teratoma for an encephalocele and demonstrates a pitfall in the interpretation of computerized tomography of these lesions.