Head and neck teratoma: from diagnosis to treatment

J Craniomaxillofac Surg. 2014 Dec;42(8):1598-603. doi: 10.1016/j.jcms.2014.04.028. Epub 2014 May 2.

Abstract

Introduction: Head and neck teratoma is a rare entity. Its prognosis mostly depends on the risk of neonatal respiratory distress, its extension and potential malignancy. Surgical management must be as complete as possible to avoid recurrences and malignant transformation. The authors present a retrospective analysis of 6 cervicofacial teratomas and a review of the literature. The aim of the study was to analyse prenatal, neonatal and postnatal management of teratoma.

Materials and methods: Charts of children presenting with a head and neck teratoma, managed by our maxillofacial and plastic surgery unit, were analysed and antenatal, clinical, biological, radiological and pathological characteristics were collected. Surgical treatment, recurrences and surgical outcomes were analysed.

Results: Six patients were included: 2 with a cervical teratoma, 2 with a facial teratoma and 2 with intraoral teratomas. In 2 cases, the lesions were diagnosed antenatally and both patients required neonatal resuscitation. All the patients underwent early surgery, and 3 with complete excisions. All patients with an initial incomplete excision eventually presented a recurrence and therefore second look surgery. No malignant transformation was noted.

Conclusion: Early prenatal diagnosis is crucial to neonatal care. Early surgery and meticulous follow-up are critical in the long-term favourable outcome.

Keywords: Benign teratoma; Cystic teratoma; Embryonic neoplasm; Germ cell neoplasm; Head and neck neoplasm; Mature teratoma.

MeSH terms

  • Chorionic Gonadotropin, beta Subunit, Human / blood
  • Facial Neoplasms / congenital
  • Facial Neoplasms / diagnosis
  • Facial Neoplasms / surgery
  • Female
  • Follow-Up Studies
  • Gestational Age
  • Head and Neck Neoplasms / congenital
  • Head and Neck Neoplasms / diagnosis*
  • Head and Neck Neoplasms / surgery
  • Humans
  • Infant, Newborn
  • Magnetic Resonance Imaging / methods
  • Male
  • Mouth Neoplasms / congenital
  • Mouth Neoplasms / diagnosis
  • Mouth Neoplasms / surgery
  • Neoplasm Recurrence, Local / pathology
  • Prenatal Diagnosis / methods
  • Respiratory Insufficiency / diagnosis
  • Retrospective Studies
  • Second-Look Surgery
  • Teratoma / congenital
  • Teratoma / diagnosis*
  • Teratoma / surgery
  • Treatment Outcome
  • Ultrasonography, Prenatal
  • alpha-Fetoproteins / analysis

Substances

  • Chorionic Gonadotropin, beta Subunit, Human
  • alpha-Fetoproteins