Three-step management of a newborn with a giant, highly vascularized, cervical teratoma: a case report
| Autor: | Zeev Winer, Liron Borenstein-Levin, Ron Avrahami, Amit Lehavi, Eitan Abargel, Philippe Abecassis, Ziv Gil, Liron Eldor, Amir Kugelman, Ofer Ben-Izhak, Asaad Khoury, Arie Gordin, Ran Stienberg, Ori Hochwald |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment lcsh:Medicine Case Report 030204 cardiovascular system & hematology Resection Congenital 03 medical and health sciences Tracheostomy 0302 clinical medicine Blood loss Pregnancy Surgical oncology Prenatal Diagnosis Intubation Intratracheal medicine Humans Embolization Endovascular embolization Ex utero intrapartum treatment Preoperative planning Cesarean Section business.industry lcsh:R Infant Newborn Teratoma General Medicine Newborn medicine.disease Embolization Therapeutic Surgery Airway Obstruction Treatment Outcome Head and Neck Neoplasms In utero 030220 oncology & carcinogenesis Female Cervical Treatment procedure business |
| Zdroj: | Journal of Medical Case Reports, Vol 13, Iss 1, Pp 1-5 (2019) Journal of Medical Case Reports |
| ISSN: | 1752-1947 |
| Popis: | Background A giant congenital cervical teratoma is often highly vascularized; thus, in addition to a life-threatening airway occlusion at birth it comprises a high risk for significant and lethal blood loss during resection. In the case presented, an endovascular embolization of the carotid artery that supplied a giant congenital cervical teratoma was done as part of a three-stage treatment soon after birth and contributed to an overall good outcome. Embolization in cases of cervical teratomas was not described previously. Case presentation We present a case of a preterm newborn from a Sephardic jewish origin with a giant, highly vascularized, congenital cervical teratoma that was managed successfully in three stages: (1) delivery by an ex utero intrapartum treatment procedure after extensive preoperative planning and followed by tracheostomy, (2) endovascular embolization of the carotid artery that supplied the tumor in order to decrease blood loss during resection, and (3) complete surgical resection. The parents were involved in all the ethical and medical decisions, starting just after the cervical mass was diagnosed prenatally. Conclusion The management of giant congenital cervical teratoma is often challenging from both a medical and ethical prospective. Meticulous perinatal planning and parents’ involvement is crucial. Endovascular embolization of the tumor feeding vessels can significantly improve the resection outcome and overall prognosis. |
| Databáze: | OpenAIRE |
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