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Three-step management of a newborn with a giant, highly vascularized, cervical teratoma: a case report

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...

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Autores principales: Hochwald, Ori, Gil, Ziv, Gordin, Arie, Winer, Zeev, Avrahami, Ron, Abargel, Eitan, Khoury, Asaad, Lehavi, Amit, Abecassis, Philippe, Eldor, Liron, Ben-Izhak, Ofer, Borenstein-Levin, Liron, Stienberg, Ran, Kugelman, Amir
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6409158/
https://www.ncbi.nlm.nih.gov/pubmed/30851737
http://dx.doi.org/10.1186/s13256-019-1976-0
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author Hochwald, Ori
Gil, Ziv
Gordin, Arie
Winer, Zeev
Avrahami, Ron
Abargel, Eitan
Khoury, Asaad
Lehavi, Amit
Abecassis, Philippe
Eldor, Liron
Ben-Izhak, Ofer
Borenstein-Levin, Liron
Stienberg, Ran
Kugelman, Amir
author_facet Hochwald, Ori
Gil, Ziv
Gordin, Arie
Winer, Zeev
Avrahami, Ron
Abargel, Eitan
Khoury, Asaad
Lehavi, Amit
Abecassis, Philippe
Eldor, Liron
Ben-Izhak, Ofer
Borenstein-Levin, Liron
Stienberg, Ran
Kugelman, Amir
author_sort Hochwald, Ori
collection PubMed
description 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.
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spelling pubmed-64091582019-03-21 Three-step management of a newborn with a giant, highly vascularized, cervical teratoma: a case report Hochwald, Ori Gil, Ziv Gordin, Arie Winer, Zeev Avrahami, Ron Abargel, Eitan Khoury, Asaad Lehavi, Amit Abecassis, Philippe Eldor, Liron Ben-Izhak, Ofer Borenstein-Levin, Liron Stienberg, Ran Kugelman, Amir J Med Case Rep Case Report 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. BioMed Central 2019-03-10 /pmc/articles/PMC6409158/ /pubmed/30851737 http://dx.doi.org/10.1186/s13256-019-1976-0 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Hochwald, Ori
Gil, Ziv
Gordin, Arie
Winer, Zeev
Avrahami, Ron
Abargel, Eitan
Khoury, Asaad
Lehavi, Amit
Abecassis, Philippe
Eldor, Liron
Ben-Izhak, Ofer
Borenstein-Levin, Liron
Stienberg, Ran
Kugelman, Amir
Three-step management of a newborn with a giant, highly vascularized, cervical teratoma: a case report
title Three-step management of a newborn with a giant, highly vascularized, cervical teratoma: a case report
title_full Three-step management of a newborn with a giant, highly vascularized, cervical teratoma: a case report
title_fullStr Three-step management of a newborn with a giant, highly vascularized, cervical teratoma: a case report
title_full_unstemmed Three-step management of a newborn with a giant, highly vascularized, cervical teratoma: a case report
title_short Three-step management of a newborn with a giant, highly vascularized, cervical teratoma: a case report
title_sort three-step management of a newborn with a giant, highly vascularized, cervical teratoma: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6409158/
https://www.ncbi.nlm.nih.gov/pubmed/30851737
http://dx.doi.org/10.1186/s13256-019-1976-0
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