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Hypertrophic Pyloric Stenosis
Joseph Junewick, MD FACR
over 8 years ago
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ARSt Case Repository

Neck Teratoma

Case Detail

Anatomy: Neck-Face
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Neoplasia Benign
Created: over 5 years ago
Updated: over 5 years ago
Tags: PEDS
Modality/Study Types: US MRI
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History

Fetus with neck mass by ultrasound.


Case Images


Diagnosis

Immature Teratoma

Clinical Notes

No family history of thyroid disease.

Findings

MR – Fetal single shot fast spin echo imaging demonstrates a macrolobulated predominantly solid mass.

US – Postnatal ultrasound shows a hyperemic “cerebriform” mass with occasional small cysts and calcifications (arrow indicates endotracheal tube).

Pathology – Sectioned surgical specimen with peripheral red-tan bosselated and central yellow-white fleshy material, representing immature teratoma containing thyroid and neural tissue.

Discussion

Teratomas of the neck, nasopharynx, pharynx, and oral cavity are usually large and bulky masses. Many of these are diagnosed on prenatal ultrasound examinations. Prenatal MRI may help narrow the differential diagnosis and evaluate the effect of the mass on the airway. Teratomas are classified as mature, immature, or malignant. Mature teratomas contain several varieties of adult tissue, while immature teratomas contain incompletely differentiated fetal tissue. Both mature and immature forms usually contain tissues from all three germ layers; neck teratomas frequently contain neural and thyroid tissue. The pathogenesis of extragonadal teratomas remains unclear, but they are thought to arise from misplaced primordial germ cells. The differential diagnostis of a predominantly solid fetal neck mass includes congenital thyroid goiter, neuroblastoma, rhabdomyodarcoma and teratoma.

Reference

Smirniotopoulos JG, Chiechi MV. Teratomas, Dermoids and Epidermoids of the Head and Neck. Radiographics (1995); 15:1437-1455.



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