Evaluation and management of congenital cervical teratoma. Case report and review.

Congenital cervical teratoma can be clinically dramatic, although essentially benign. Prognosis is good provided that the airway is quickly stabilized and resection is not delayed. We present a case of massive cervical teratoma diagnosed using antenatal magnetic resonance imaging. The child was maintained on maternal circulation after cesarean section until successfully intubated, with a second team ready for emergent bronchoscopy or tracheotomy. After delivery, the lesion grew rapidly with persistent bleeding; biopsy revealed a benign, immature teratoma. On computed tomography all anatomy ventral to the vertebrae was obliterated. At surgery, however, the tumor was easily resected. The literature is reviewed, with attention to malignancy in neonatal cervical teratoma. Surgery was delayed because of the aggressive imaging appearance and rapid growth. This case suggests that when evaluating neonatal tumors, the standard criteria for infiltration and resectability may require modification.