Epignathus in the neonatal period: an unexpected finding

Area of Science:

• Congenital Malformations
• Pediatric Surgery
• Neonatal Medicine

Background:

• Epignathus is a rare congenital teratoma presenting a significant risk of neonatal upper airway obstruction.
• This case report details a full-term neonate diagnosed with epignathus without prior prenatal detection.

Purpose of the Study:

• To highlight the critical importance of early, multidisciplinary intervention in managing epignathus.
• To present an updated review of epignathus, emphasizing its association with airway compromise.

Main Methods:

• A case report of a neonate with epignathus presenting with severe respiratory distress at birth.
• Diagnostic imaging, blood tumor markers (alpha-fetoprotein), and histopathological analysis were utilized.
• Surgical resection of the teratoma was performed on day five, with subsequent positive pressure ventilation.

Main Results:

• The neonate presented with severe airway obstruction due to a hard palate tumor and cleft palate.
• Diagnostic imaging revealed a teratoma with dental structures; elevated alpha-fetoprotein supported the diagnosis.
• Histopathology confirmed the tumor as a teratoma, and the infant showed favorable clinical progress post-surgery.

Conclusions:

• Epignathus poses a high risk of neonatal mortality primarily due to airway obstruction.
• Prompt multidisciplinary intervention and surgical management are vital for improving patient outcomes.
• This case underscores the need for awareness and timely management of congenital teratomas like epignathus.