Natacha Kadlub1, Joseph Touma2, Nicolas Leboulanger3, Catherine Garel4, Véronique Soupre2, Aurore Coulomb L'Herminé5, Marie-Paule Vazquez6, Arnaud Picard7. 1. Service de Chirurgie Maxillofaciale et Plastique, Hôpital Necker Enfants Malades, APHP, 75015 Paris, France; Centre de Référence des Maladies Rares de la Cavité Buccale, MAFACE, 75015 Paris, France; INSERM, UMRS872, Equipe 5 Biologie Orale Moléculaire, 75006 Paris, France; Université Paris Descartes, 75006 Paris, France. Electronic address: natacha.kadlub@nck.aphp.fr. 2. Service de Chirurgie Maxillofaciale et Plastique, Hôpital Necker Enfants Malades, APHP, 75015 Paris, France; Centre de Référence des Maladies Rares de la Cavité Buccale, MAFACE, 75015 Paris, France. 3. Université Paris Descartes, 75006 Paris, France; Service d'ORL et Chirurgie Cervico-faciale, Hôpital Necker Enfants Malades, APHP, 75015 Paris, France. 4. Service d'Imagerie Médicale, Hôpital d'Enfants Armand Trousseau, APHP, 75012 Paris, France. 5. Service d'Anatomopathologie et cytologie, Hôpital d'Enfants Armand Trousseau, APHP, 75012 Paris, France; Université Pierre et Marie Curie, Faculté de Médecine Paris 6, 75005 Paris, France. 6. Service de Chirurgie Maxillofaciale et Plastique, Hôpital Necker Enfants Malades, APHP, 75015 Paris, France; Centre de Référence des Maladies Rares de la Cavité Buccale, MAFACE, 75015 Paris, France; INSERM, UMRS872, Equipe 5 Biologie Orale Moléculaire, 75006 Paris, France; Université Paris Descartes, 75006 Paris, France. 7. Service de Chirurgie Maxillofaciale et Plastique, Hôpital Necker Enfants Malades, APHP, 75015 Paris, France; Centre de Référence des Maladies Rares de la Cavité Buccale, MAFACE, 75015 Paris, France; INSERM, UMRS872, Equipe 5 Biologie Orale Moléculaire, 75006 Paris, France; Université Pierre et Marie Curie, Faculté de Médecine Paris 6, 75005 Paris, France.
Abstract
INTRODUCTION: Head and neck teratoma is a rare entity. Its prognosis mostly depends on the risk of neonatal respiratory distress, its extension and potential malignancy. Surgical management must be as complete as possible to avoid recurrences and malignant transformation. The authors present a retrospective analysis of 6 cervicofacial teratomas and a review of the literature. The aim of the study was to analyse prenatal, neonatal and postnatal management of teratoma. MATERIALS AND METHODS: Charts of children presenting with a head and neck teratoma, managed by our maxillofacial and plastic surgery unit, were analysed and antenatal, clinical, biological, radiological and pathological characteristics were collected. Surgical treatment, recurrences and surgical outcomes were analysed. RESULTS: Six patients were included: 2 with a cervical teratoma, 2 with a facial teratoma and 2 with intraoral teratomas. In 2 cases, the lesions were diagnosed antenatally and both patients required neonatal resuscitation. All the patients underwent early surgery, and 3 with complete excisions. All patients with an initial incomplete excision eventually presented a recurrence and therefore second look surgery. No malignant transformation was noted. CONCLUSION: Early prenatal diagnosis is crucial to neonatal care. Early surgery and meticulous follow-up are critical in the long-term favourable outcome.
INTRODUCTION: Head and neck teratoma is a rare entity. Its prognosis mostly depends on the risk of neonatal respiratory distress, its extension and potential malignancy. Surgical management must be as complete as possible to avoid recurrences and malignant transformation. The authors present a retrospective analysis of 6 cervicofacial teratomas and a review of the literature. The aim of the study was to analyse prenatal, neonatal and postnatal management of teratoma. MATERIALS AND METHODS: Charts of children presenting with a head and neck teratoma, managed by our maxillofacial and plastic surgery unit, were analysed and antenatal, clinical, biological, radiological and pathological characteristics were collected. Surgical treatment, recurrences and surgical outcomes were analysed. RESULTS: Six patients were included: 2 with a cervical teratoma, 2 with a facial teratoma and 2 with intraoral teratomas. In 2 cases, the lesions were diagnosed antenatally and both patients required neonatal resuscitation. All the patients underwent early surgery, and 3 with complete excisions. All patients with an initial incomplete excision eventually presented a recurrence and therefore second look surgery. No malignant transformation was noted. CONCLUSION: Early prenatal diagnosis is crucial to neonatal care. Early surgery and meticulous follow-up are critical in the long-term favourable outcome.