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Cervical Teratoma / CT is a rare tumor of the neck made up of a variety of tissues (nerves, cartilage, skin and thyroid, among others) that come from more than one embryonic layer.
Since 2004, we have evaluated more than 55 patients for fetal tumors, including cervical, mediastinal and sacrococcygeal teratomas, neuroblastoma and renal masses.
The cause of Cervical Teratoma is unknown. An old theory holds that it is caused by an inability of cells to develop into a complete body, or an abnormal development of a conjoined twin. More likely, Cervical Teratoma arises from stem cells within the thyroid gland that grow abnormally into a tumor.
Over 150 cases of congenital Cervical Teratoma have been reported.
An ultrasound is usually the best way to make a diagnosis. Cervical Teratomas are asymmetric, well-defined masses usually off to one side of the baby's neck. As many as 50 percent of Cervical Teratomas have calcifications. The Cervical Teratoma is typically large and bulky, measuring five to 12 cm. in diameter.
These tumors may grow larger than the fetal head. Polyhydramnios (too much amniotic fluid) can complicate 20 to 40 percent of prenatally diagnosed cases. Other fetal abnormalities have been reported in association with Cervical Teratoma.
Frequent ultrasound exams are recommended to monitor amniotic fluid volume, tumor size, growth and the general health of the fetus. Premature labor and delivery in cases of Cervical Teratoma are common. The increase in the size of the uterus due to polyhydramnios can precipitate preterm labor and / or delivery.
This may necessitate an emergency EXIT (ex utero intrapartum treatment) procedure to secure the newborn's airway at delivery. Airway obstruction can be life threatening and accounts for up to 45 percent of the mortality associated with Cervical Teratoma.
Because Cervical Teratoma may block the fetal airway, an EXIT procedure may be used to deliver the baby and be sure that the airway is open at birth. In rare cases in which hydrops (in utero heart failure) develops earlier in gestation (at < 30 weeks), open fetal surgery to remove the Cervical Teratoma may be necessary to save the baby.
We have performed 11 EXIT-to-Airway procedures at the Fetal Care Center to treat patients with cervical teratomas.
Click for larger image.
If you would like to request an appointment or get more information about the Fetal Care Center of Cincinnati, please call us at 1-888-338-2559 (1-888-FETAL59).
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