Large congenital cervical teratoma in a neonate: EXIT procedure under spinal anesthesia and early surgical excision
Merve Yaman1, Süleyman Camgöz2, Serkan Telli2
1Department of Anesthesiology and Resuscitation, Faculty of Medicine, Kütahya University of Health Sciences, Kütahya, Türkiye. merve.yaman@ksbu.edu.tr.
Background:
Cervical teratomas are rare congenital tumors in neonates associated with high morbidity and mortality due to the potential for severe airway obstruction at birth. Here, we present a case of successful airway management using an ex utero intrapartum treatment (EXIT) procedure under spinal anesthesia for a prenatally detected cervical mass, with definitive treatment achieved by postnatal surgical excision.
Case:
The infant was born via emergency cesarean section after exhibiting fetal distress due to a cervical mass and underwent an EXIT procedure under spinal anesthesia. A surgical tracheostomy was performed as the newborn could not be intubated. On postnatal day 6, a 439-g cervical teratoma was successfully removed, and the patient was discharged on postnatal day 48.
Conclusions:
This case suggests that spinal anesthesia may represent a viable anesthetic option for EXIT procedures in neonates with cervical teratoma in selected emergency settings while maintaining uteroplacental circulation and enabling rapid airway control.