Head and neck teratomas in children--A series of 23 cases at Great Ormond Street Hospital

Int J Pediatr Otorhinolaryngol. 2015 Dec;79(12):2008-14. doi: 10.1016/j.ijporl.2015.07.042. Epub 2015 Aug 22.

Abstract

Objective: Head and neck teratomas are rare and malignant change is rarer still. This is a report detailing all of the teratomas treated by the ear, nose and throat or craniofacial teams over the last 28 years at our institution. Examining the common presenting and radiological features as well as our success rates compared to the current literature.

Method: A retrospective review of all cases presenting to our institution with a head and neck teratoma were analysed. Data regarding the following characteristics were collected: antenatal history, clinical features, biological serum makers, radiological and pathological characteristics. Surgical treatment, rates of reoccurrence and the degree of post-operative follow up were also analysed.

Results: 23 cases in total were included: 8 cervical, 6 nasopharyngeal, 5 thyroid, 2 thymus, 2 temporal. One had malignant change. The majority of children presented at birth with respiratory distress, 5 cases were picked up antenatally and one case presented at 10 years of age. All were treated surgically; with complete excision in 20 patients. No clinical recurrence occurred but further surgery was performed for radiologically suspected residual disease in one case.

Discussion: This is the largest detailed case series in literature in regard to head and neck teratomas. Illustrating that this is frequently a benign disease process disease in the head and neck region and has an excellent long term prognosis following surgery. In the situation of incomplete resection careful meticulous follow up with radiological imaging and a multidisciplinary team approach is a safe and viable alternative.

Keywords: Cervical mass; Ex utero intrapartum treatment procedure; Germ cell tumour; Malignancy; Polyhydramnios; Teratoma.

MeSH terms

  • Child
  • Child, Preschool
  • Female
  • Head and Neck Neoplasms / pathology*
  • Head and Neck Neoplasms / surgery
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Neoplasm Recurrence, Local
  • Prognosis
  • Retrospective Studies
  • Teratoma / pathology*
  • Teratoma / surgery