335 results on '"Epignathus"'
Search Results
52. Epignathus, hypolastic left heart syndrome, and trisomy 18 in a small for gestational age female twin
- Author
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S. Rugolotto, A. Bertolini, I. Cogo, A. Pietrobelli, S. Pecori, M. Furlani, and E.M. Padovani
- Subjects
Epignathus ,SGA ,hypoplastic left heart syndrome ,trisomia 18 ,Pediatrics ,RJ1-570 ,Surgery ,RD1-811 - Abstract
We describe a rare association of hypoplastic left heart syndrome, trismony 18, and epignathus in a 970 g female twin born at 37 weeks of gestational age. She died at 24 hours of age. Neonatologists and obstetricians should be aware of this rare association for a thorough prenatal counselling.
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- 2013
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53. Emergency management of a congenital teratoma of the oral cavity at birth and three-year follow-up.
- Author
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Dakpé, S., Demeer, B., Cordonnier, C., and Devauchelle, B.
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TERATOMA ,EMERGENCY medicine ,PRENATAL diagnosis ,FOLLOW-up studies (Medicine) ,TUMORS in infants ,TUMOR surgery ,THERAPEUTICS - Abstract
Abstract: Teratomas are congenital malformations that are rarely located in the head and neck region. We report a case of congenital teratoma of the oral cavity, which was causing an airway obstruction and was treated at the time of birth. This teratoma was discovered at 27 gestational weeks by ultrasonography. A multidisciplinary team was consulted for antenatal diagnosis; the options of therapeutic abortion or management of the birth with the prevention of respiratory distress were debated. However, preterm labour at 32 gestational weeks accelerated the parental and the medical decisions. The parents agreed to the birth. The various disciplines coordinated their work, and the predefined treatment plan for clearing the airway obstruction was applied to manage the birth. The reestablishment of patency of the airway was performed during delivery and removal of the tumour was performed immediately afterwards. The follow-up of this case over 3 years is also presented. [Copyright &y& Elsevier]
- Published
- 2014
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54. Prenatal Assessment of a Fast-Growing Giant Epignathus.
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Faghfouri, Farahnaz, Bucourt, Martine, Garel, Catherine, Benchimol, Michel, Amarenco, Brigitte, Soupre, Véronique, Benbara, Amélie, and Carbillon, Lionel
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PRENATAL care , *MEDICAL needs assessment , *CANCER in infants , *RARE diseases , *TUMOR growth , *MAGNETIC resonance imaging of cancer , *ULTRASONIC imaging of cancer , *MEDICAL decision making - Abstract
Epignathus is a very rare fetal tumor. We report a case of fast-growing giant epignathus with severe distortion of the right part of the face and orbit. A thorough prenatal work-up was performed by the association of Magnetic Resonance Imaging and Ultrasonography. A multidisciplinary approach was crucial to assess the operability and provide careful counseling to help parents understand and reach decision. [ABSTRACT FROM AUTHOR]
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- 2014
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55. An Unusual Lesion of Epignathus with Duplicate Tongue and Ranula in a Neonate
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Sudhagar Eswaran, Sunil Kumar, and Poornima Kumar
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medicine.medical_specialty ,EXIT procedure ,business.industry ,Prenatal diagnosis ,Ranula ,medicine.disease ,Epignathus ,Bifid tongue ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Otorhinolaryngology ,Tongue ,030220 oncology & carcinogenesis ,medicine ,Teratoma ,Presentation (obstetrics) ,030223 otorhinolaryngology ,business - Abstract
We report a rare case of epignathus (oropharyngeal teratoma) in a neonate, who presented with a midline mass covered with skin and multiple hairs protruding from the Palate and associated with bifid tongue and ranula. With the characteristic presentation, diagnosis of oro/oropharyngeal teratoma was made and a massive internet search revealed very few reported cases of “epignathus”. It is unfortunate that the survival of such neonates is only moderate. Prenatal scans and follow up in an institution can prepare the multidisciplinary team to save the child. EXIT procedure to excise the mass or secure the airway, with future repair of the palate is the treatment option available. This case report emphasizes the rare clinical presentation of the disease and the prenatal diagnosis of such a condition can help in prompt decision making and management.
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- 2020
56. Unusual Cause of Neonatal Stertor
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Suma Susan Mathews, Sophia Amalanathan, and Vedantam Rupa
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Pediatrics ,medicine.medical_specialty ,Perinatal mortality ,business.industry ,Neonatal respiratory distress ,Epignathus ,Stertor ,Otorhinolaryngology ,Current management ,medicine ,Head and neck surgery ,Surgery ,medicine.symptom ,business - Abstract
We report a case of neonatal respiratory distress caused by an epignathus. This rare tumour, arising from the basisphenoid and protruding from the mouth, is associated with high perinatal mortality. We highlight unique clinico-radiological findings and multidisciplinary approach for a successful outcome. We review oropharyngeal teratomas reported in the literature with current management approaches.
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- 2020
57. Non-operating room anaesthesia for residual neonatal epignathus: Small pill, big thrill…
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Akhil Dhanesh Goel, Amrit Kaur, Raylene Dias, and Harick Shah
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medicine.medical_specialty ,Anesthesiology and Pain Medicine ,business.industry ,Anesthesiology ,Pill ,General surgery ,medicine ,RD78.3-87.3 ,Epignathus ,Residual ,business - Published
- 2021
58. Perinatal management of congenital oropharyngeal tumors: The ex utero intrapartum treatment (EXIT) approach.
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Laje, Pablo, Howell, Lori J., Johnson, Mark P., Hedrick, Holly L., Flake, Alan W., and Adzick, N. Scott
- Abstract
Abstract: Purpose: To present our experience in the perinatal management of fetuses with large oropharyngeal tumors by ex utero intrapartum treatment (EXIT). Methods: We performed a retrospective chart review of all patients with congenital oropharyngeal tumor who underwent an EXIT procedure between May 2006 and June 2012. Results: Four patients were included in the series, three females and one male. The diagnoses were epignathus (n =2) and congenital epulis (n =2). Three EXITs were done at term and one at late preterm due to premature rupture of membranes. Median maternal time under anesthesia was 185min (range: 166–281) and median maternal operative time was 99min (range: 85–153). Median maternal blood loss was 550ml (range: 350–2000); one mother required a blood transfusion. Mean maternal hospital stay was 4days. Median hysterotomy-to-cord clamp time was 24min (range: 18–66). Mean fetal birth weight was 2.7kg (range: 2.4–3). The airway was successfully accessed and secured under placental circulation in all cases. In the two patients with congenital epulis the tumors were resected at the base of their pedicles and the airway accessed via direct laryngoscopy before the umbilical cord was clamped. One patient with epignathus underwent a retrograde tracheal intubation under placental circulation and had the tumor resected thereafter. The second patient with epignathus had a tracheostomy done under placental circulation and then had tumor debulking immediately after the EXIT. The maternal morbidity was minimal and there were no mortalities. Conclusions: We conclude that the EXIT procedure is the ideal delivery strategy for fetuses with prenatally diagnosed oropharyngeal tumors and potential airway obstruction at birth. Patients with prenatally diagnosed oropharyngeal tumors should be promptly referred to a fetal treatment center with a dedicated multidisciplinary team and EXIT capabilities. [Copyright &y& Elsevier]
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- 2013
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59. Hairy polyp can be lethal even when small in size.
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Koike, Yuhki, Uchida, Keiichi, Inoue, Mikihiro, Ohtsu, Kazuya, Tanaka, Takaaki, Otake, Kohei, Tanaka, Koji, and Kusunoki, Masato
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HUMAN abnormalities , *DISEASE complications , *TREATMENT effectiveness - Abstract
A case of sudden cardiopulmonary arrest in a 3-month-old girl is presented. The patient had barely recovered from hypoxic encephalopathy when she presented with repeated respiratory distress. Computed tomography and endoscopic analysis revealed a shiny polyp in the lateral wall of the nasopharynx, and this polyp was suspected to be the main cause of respiratory distress. After referral to our hospital, surgical removal was performed, and the histopathological diagnosis was hairy polyp. Hairy polyp is a rare congenital benign tumor that sometimes induces respiratory distress. This polyp can potentially induce a life-threatening event. In a systematic review of 40 reported cases, polyps of ≤3.0 cm in diameter have a higher risk of respiratory distress than do those >3.0 cm in diameter ( P = 0.01). Small hairy polyps may be lethal because of delayed diagnosis. To locate small hairy polyps, physicians should not hesitate to perform further examination because there is the possibility of oversight with only physical examination. [ABSTRACT FROM AUTHOR]
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- 2013
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60. Epignathus Teratoma With Duplication of Mandible and Tongue: Report of a Case.
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Yun-Ta Tsai, Cala-Or, Ma. Arlene Cirineo, Chun-Chung Lui, Tzu-Jou Wang, and Jui-Pin Lai
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TONGUE abnormalities ,MANDIBLE abnormalities ,OPERATIVE surgery ,ACADEMIC medical centers ,MAGNETIC resonance imaging ,QUALITY of life ,TERATOMA ,TOMOGRAPHY - Abstract
We report a female infant with presentation of epignathus teratoma involving duplication of both the mandible and tongue. Epignathus with duplication of the mandible has rarely been reported in the literature thus far. The location and extent of the tumor, as well as the involvement of adjacent structures, resulted in trismus and upper airway obstruction at birth. Thus, staged operations including debulking and correction of anatomical anomaly were performed on this patient after life-saving tracheostomy. As a result, we not only prevented morbidity associated with the anomaly but also refined the patient's appearance and improved her quality of life. [ABSTRACT FROM AUTHOR]
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- 2013
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61. Prenatal ultrasound and magnetic resonance imaging findings of a hypovascular epignathus with a favorable prognosis.
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Kaido, Yoshitaka, Kikuchi, Akihiko, Oyama, Rie, Kanasugi, Tomonobu, Fukushima, Akimune, and Sugiyama, Toru
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Epignathus of a fetus is an extremely rare type of an oropharyngeal teratoma that commonly arises from the palate and often grows in the prenatal period, leading to polyhydramnios due to difficulty in swallowing before birth and a high mortality due to the airway obstruction after birth. We report here a very rare case of a fetus with an epignathus decreasing in size naturally in the prenatal period with a favorable prognosis. In contrast to previously reported cases of epignathus that grew rapidly in the prenatal period, color Doppler fetal ultrasound showed a hypovascular tumor in our case. Moreover, histopathologic examination revealed an epignathus with necrotic areas inside. Based on our experience, a hypovascular epignathus demonstrated by color Doppler fetal ultrasound may be an indicator of a favorable prognosis. [ABSTRACT FROM AUTHOR]
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- 2013
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62. An autopsy case of epignathus (immature teratoma of the soft palate) with intracranial extension but without brain invasion: case report and literature review
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Kirishima, Mari, Yamada, Sohsuke, Shinya, Mitsuhisa, Onishi, Shun, Goto, Yuko, Kitazono, Ikumi, Hiraki, Tsubasa, Higashi, Michiyo, Hida, Akira I., and Tanimoto, Akihide
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- 2018
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63. Giant epignathus with midline mandibular cleft: Insights in embryology and management.
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Prakash, Advait, Parelkar, Sandesh V., Oak, Sanjay N., Gupta, Rahul K., and Sanghvi, Beejal V.
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FETUS ,TERATOMA ,DERMOID cysts ,MANDIBLE ,EMBRYOLOGY - Abstract
A congenital teratoid tumor arising and protruding through the mouth is classified as epignathus or fetus in fetu. On review of literature, we found various reports of midline mandibular and lower lip cleft associated with flexion contracture of neck, midline cervical cord, but there is only one report of association with midline dermoid. We present an unusual case of midline cleft of mandible with an epignathus. A 2.3-kg male child, delivered transvaginally in the 38th gestational week, was referred to us for management of a large irregular growth hanging outside the mouth. On examination, he had a wide median cleft of the mandible with tongue adherent to the "V"-shaped defect in the area of lower lip. A midline irregular mass of size 12 x 8 x 5 cm with variegated consistency was arising in the midline from the floor of the mouth between the tongue and lower lip. X-ray and computed tomography scan showed a rounded soft tissue mass arising from the alveolus with multiple calcifications within it along with a large triangular calcification and absence of hyoid bone. The mass was excised by mobilizing the tip of tongue. Staged repair was planned for the defect in the mandible. Unfortunately, the baby succumbed postoperatively to complex congenital heart disease. Histopathology was suggestive of epignathus. We discuss hereby the embryology and current management strategies of the problem. [ABSTRACT FROM AUTHOR]
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- 2012
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64. Congenital Nasopharyngeal Teratoma with a Cleft Palate: Case Report and a 7 Year Follow Up.
- Author
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Chauhan, Dinesh, Guruprasad, Yadavalli, and Inderchand, Singhvi
- Abstract
Teratomas are benign tumors containing cells from ectodermal, mesodermal and endodermal layers. They occur in about 1 in every 4,000 births and most commonly in the sacrococcygeal region, followed by the ovaries. Congenital epignathus teratomas are rare embryological neoplasms localised in the region of head and neck. An epignathus is found in approximately 1:35,000-1:200,000 live births. This accounts for 2-9% of all teratomas. Size and location of the neoplasm in the oronasopharynx is variable. Teratomas are partly undiagnosed at the time of birth. They may exist with an intracranial extension or as small polyps. Large epignathi can lead to difficult management during and after birth. We present a case of a female infant with a combination of nasopharyngeal teratoma and a cleft palate with successful multidisciplinary management via a staged surgical approach. The epignathus presented as a huge mass extending out of the mouth of the infant girl. On the day of birth debulking of the extraoral portion of the tumor, followed by intraoral extirpation and cleft palate repair at a later stage, was performed. The results of the histopathological examination confirmed diagnosis of a congenital teratoma. [ABSTRACT FROM AUTHOR]
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- 2011
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65. Complete peripartum airway management of a large epignathus teratoma: EXIT to resection
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Roby, Brianne Barnett, Scott, Andrew R., Sidman, James D., Lander, Timothy A., and Tibesar, Robert J.
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TERATOMA , *AIRWAY (Anatomy) , *CASE studies , *PRENATAL diagnosis , *ULTRASONIC imaging , *DISEASE management ,PHARYNX tumors - Abstract
Abstract: We present a case of a female infant that was diagnosed on prenatal ultrasound with an oral mass, and subsequently underwent a planned EXIT procedure to secure the airway. Ultimately the epignathus teratoma was excised at 3 days of age. The number of cases in which neonates have survived epignathus teratomas has increased in the past decade due to improved prenatal imaging and the development of the EXIT procedure. This case demonstrates the importance of a multidisciplinary approach that must be established when a prenatal diagnosis raises concern for airway compromise, and the thorough work-up required for definitive management. [Copyright &y& Elsevier]
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- 2011
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66. A case of an epignathus with intracranial extension appearing as a persistently open mouth at 16 weeks and subsequently diagnosed at 20 weeks of gestation.
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Calda, Pavel, Novotná, Michaela, Čutka, David, Břešt'ák, Miroslav, Hašlík, Lubomír, Goldová, Barbara, Vítková, Ivana, Vaněčková, Manuela, and Seidl, Zdeněk
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CASE studies ,TERATOMA ,MEDICAL imaging systems ,FETAL abnormalities ,ULTRASONIC imaging ,DOWN syndrome - Abstract
The article presents a case report of a 16-week-old fetus suspected to have epignathus during ultrasound examination because of the finding of a persistently open mouth. Postmortem MRI and pathologic examination of the fetus at 20 weeks confirmed the diagnosis. The article discusses epignathus, a rare form of benign congenital teratoma, with intracranial extension on a 16-week old fetus.
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- 2011
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67. Cervical and oral teratoma in the fetus: a systematic review of etiology, pathology, diagnosis, treatment and prognosis.
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Tonni, Gabriele, De Felice, C., Centini, G., and Ginanneschi, C.
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TERATOMA , *FETUS , *ETIOLOGY of diseases , *DIAGNOSTIC imaging , *OBSTETRICAL diagnosis - Abstract
Introduction: The aim of the study was to produce a systematic review about etiology, pathology, diagnosis, prognosis and clinical management regarding oral and cervical teratomas. Materials and methods: A systematic review of Pubmed/Medline using the following keywords was made: epignathus, cervical teratoma, fetus, oral teratoma, prenatal diagnosis, prognosis, treatment, ultrasound. Conclusion: The following clinical conclusions can be reached: (1) teratomas are rare, usually benign congenital tumors which recognized multifactorial etiology; (2) prenatal ultrasound diagnosis can be made early in pregnancy (15–16 weeks); (3) 3D ultrasound and MRI may enhance the accuracy of the antenatal diagnosis (location, extension and intracranial spread) and may aid in the selection of patients requiring treatment; (4) prenatal karyotype and search for associated abnormalities is mandatory in all teratomas; (5) delivery should involve elective Cesarean section with ex utero intrapartum treatment procedure or resection of the tumor mass, which may be performed on placental support operation on placental support procedure to increase the chances of postnatal survival. [ABSTRACT FROM AUTHOR]
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- 2010
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68. Massive immature teratoma in a neonate.
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Sumiyoshi, S., Machida, J., Yamamoto, T., Fukano, H., Shimozato, K., Fujimoto, Y., and Kaetsu, A.
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TERATOMA ,EMBRYONAL tumors ,NEONATAL diseases ,TUMORS in infants ,GERMINAL layers ,TRACHEOTOMY ,ALPHA fetoproteins ,DRUG therapy - Abstract
Abstract: Teratomas are embryonal tumours composed of diverse tissues from three germinal layers with variable levels of maturity. The authors report a female patient with a large immature epignathus. Prenatal diagnosis permitted a caesarean section and tracheotomy to be planned under ex utero intrapartum treatment for airway obstruction. The tumour was successfully controlled, even though it was impossible to distinguish from normal tissue because it lacked a pedicle and capsule, using multidisciplinary therapy, including a series of surgical treatments and adjuvant chemotherapy. This case suggested that the level of serum alpha fetoprotein might be a useful indicator after surgery. At present, after 4 years, no regrowth has been observed and the patient has no problems with respiration or swallowing. [ABSTRACT FROM AUTHOR]
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- 2010
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69. Prenatal Diagnosis of Severe Epignathus in a Twin: Case Report and Review of the Literature.
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Tonni, Gabriele, Centini, Giovanni, Inaudi, Pieraldo, Rosignoli, Lucia, Ginanneschi, Chiara, and de Felice, Claudio
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PRENATAL diagnosis ,TUMOR growth ,ABORTION ,AUTOPSY ,HISTOLOGY - Abstract
A prenatal ultrasound diagnosis of epignathus in a dichorionic-diamniotic twin pregnancy is reported. A complex mass protruding from the fetal face was seen at week 19. Amniocentesis resulted in a 46,XX fetus with elevated alphafetoprotein (a-FP). An increase in tumor size and severe polyhydramnios ensued. Selective feticide performed at 22 weeks led to untreatable uterine contractions with iatrogenic abortion and early neonatal mortality of the healthy cotwin. Without development of polyhydramnios and tumor growth, weekly scan and transvaginal cervical assessment would have been carried out and cesarean section planned at around 32 weeks. Necroscopy and histology aided the ultrasound-based prenatal diagnosis. [ABSTRACT FROM AUTHOR]
- Published
- 2010
- Full Text
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70. Epignatus Reporte de un caso.
- Author
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Navarrete-Arellano, Mario and Soto-Fernández, Adrian Eliseo
- Subjects
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GENETIC disorders in children , *PRENATAL diagnosis , *MAGNETIC resonance imaging , *HISTOLOGY - Abstract
Introduction: epignathus is a congenital teratoma of the oropharyngeal cavity, is presented as a mass of tissue is exposed on the outside through the oral cavity, the histology is benign and can cause severe obstruction of the airway and / or digestive tract. At birth it is essential to secure the airway and then removed the tumor. We present this case because it is very rare. Case report: A newly born female, obtained via cesarean for prenatally detected tumor apparently chin, the mouth showed tumor protrusion. He secured the airway with Guedel airway. Establishing a diagnosis of intraoral teratoma: Epignatus. The histopathological report was intraoral teratoma. The evolution to date is satisfactory with 6 months follow up. Discussion: epignatus is a teratoma of the oral cavity is rare and protrudes through the mouth. It is a benign, but mortality is high because it causes airway obstruction at birth. Prenatal diagnosis can be established with USG or MRI, and treatment is surgical resection. Because of its benign histology is virtually free from recurrence. [ABSTRACT FROM AUTHOR]
- Published
- 2010
71. Brain malformations associated with epignathus: a clue for the correct prenatal diagnosis.
- Author
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Calvo-Garcia, Maria A., Kline-Fath, Beth M., Jones, Blaise B., Care, Marguerite M., and Koch, Bernadette L.
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TERATOMA , *HUMAN abnormalities , *MAGNETIC resonance imaging , *BRAIN abnormalities , *DIAGNOSIS , *PITUITARY disease complications - Abstract
We present a case of epignathus (oral teratoma) with midline intracranial associated malformations. This is a rare report of epignathus diagnosed in utero with fetal MRI description of these midline brain malformations, including duplication of the pituitary gland. This case is an example of how these intracranial findings led to the correct diagnosis of a small fetal oral mass. [ABSTRACT FROM AUTHOR]
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- 2009
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72. EPIGNATHUS (A CLINICOPATHOLOGIC CASE REPORT).
- Author
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Shertukde, Savita P. and Thelmo, Mary Lou C.
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CASE studies , *WOMEN , *OVERWEIGHT persons , *PREGNANCY , *PREMATURE labor , *INFANTS , *ENCEPHALOCELE , *NEURAL tube defects - Abstract
The article presents the case of a 26-year-old obese woman who was diagnosed with polyhydramnios and a large encephalocele at almost seven months of gestation. She was admitted into preterm labor, resulted in cesarean section, and born a female infant. The infant passed though a physical examination and revealed epignathus or a large mass protruding from her mouth that attached to the palate.
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- 2009
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73. Epignato: teratoma orofaríngeo. Comunicación de un caso.
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Flores-Acosta, Clara del Carmen, Villagómez-Martínez, Gabriel Edgar, Soria-López, Juan Antonio, Ambriz-López, Roberto, and Iglesias-Benavides, José Luis
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TERATOMA , *TUMORS , *ORAL diseases , *PHARYNGEAL diseases , *THROAT diseases ,DIAGNOSIS of neonatal diseases - Abstract
Epignathus is an oropharyngeal teratoma, which has an incidence of 1:35000 to 1:200000 in those born alive. This oropharyngeal teratoma arises from the base of the skull or of the posterior wall of the pharynx and it extends inferiorly causing partial or complete obstruction of the airway and digestive passage. That is the reason why prenatal diagnosis is important to establish a suitable and immediate handling plan to improve the survival of the newborn. A case of epignathus in a woman in her first pregnancy and in the 32nd week of gestation reported and to which the diagnosis was made prenatally through an ultrasound and corroborated at birth. [ABSTRACT FROM AUTHOR]
- Published
- 2009
74. Head and neck teratomas.
- Author
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Shah, Ajaz, Latoo, Suhail, Ahmed, Irshad, and Malik, Altaf.
- Abstract
Teratomas are complex lesions composed of diverse tissues from all 3 germinal cell layers and may exhibit variable levels of maturity. Head and neck teratomas are most commonly cervical with the oropharynx (epignathus) being the second commonest location. In this article, clinical presentation, behaviour and associated significance of head and neck teratomas have been highlightened. Because of their obscure origin, bizarre microscopic appearance, unpredictable behaviour and often dramatic clinical presentation, a dental surgeon or a dental specialist should be aware of their clinical presentation and pathology. [ABSTRACT FROM AUTHOR]
- Published
- 2009
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75. Prenatal Diagnosis of an Epignathus Associated with a 49,XXXXY Karyotype – A Case Report.
- Author
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Staboulidou, Ismini, Miller, Konstantin, Göhring, Gudrun, Hillemanns, Peter, and Wüstemann, Max
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TERATOMA , *TUMORS , *CESAREAN section , *PREGNANCY , *PROGNOSIS - Abstract
Background: Epignathus is a rare form of congenital teratoma, originating from the base of the skull, most commonly the hard palate, or mandible. It has been associated with a poor prognosis due to complications including polyhydramnios and respiratory compromise at birth as a consequence of upper airway obstructions. It is usually not associated with chromosomal aberrations. We present a case of prenatally diagnosed epignathus associated with a gonosomal pentasomy 49,XXXXY. Case: A 34-year-old gravida 1, para 0 was referred to our unit with a sonographically suspected gastroschisis at 26+6 weeks’ gestation. A detailed ultrasound scan revealed a large mixed echogenic mass seen in continuation with the mouth in the midline. Based on the appearance, an epignathus was suspected. No other fetal anomalies were detected. Karyotyping showed a 49,XXXXY karyotype of the fetus. The couple decided to continue the pregnancy after detailed counseling about results and prognosis. A cesarean section was necessary and performed at 29+0 weeks’ gestation due to a pathological Doppler and cardiotocogram. Because of the enormous epignathus intubation of the newborn was not possible. A tracheostomy was performed for ventilation and oxygenation, which failed and the newborn died 30 min after birth. Conclusion: Prenatal diagnosis by ultrasound has improved perinatal management. This should include assessment of the tumor size and spread in order to establish an accurate prognosis and to anticipate likely problems which are to be encountered during pregnancy or at the time of delivery. To our knowledge, this is the first reported case of a prenatally diagnosed epignathus with a gonosomal pentasomy 49,XXXXY. Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]
- Published
- 2008
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76. The EXIT (ex utero intrapartum treatment) procedure.
- Author
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Chiu, Hsin-Hui, Hsu, Wei-Chung, Shih, Jin-Chung, Tsao, Po-Nien, Hsieh, Wu-Shiun, and Chou, Hung-Chieh
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HYSTEROSCOPY ,MORTALITY ,HOSPITAL admission & discharge ,SOCIAL indicators - Abstract
Fetuses with upper airway obstruction have a high mortality rate if proper airway management is not immediately administered after delivery. The EXIT (ex utero intrapartum treatment) procedure is a new technique that establishes the fetal airway while uteroplacental circulation is still maintained. The prognosis of such neonates has much improved after the introduction of this procedure. We report two neonates with prenatal diagnosis of upper airway obstruction; they were born smoothly via the EXIT procedure. The first was a case of epignathus, a rare type of nasopharyngeal or oropharyngeal teratoma derived from all three germ cell layers with variable maturity. The second was a case of giant lymphangioma that resulted from localized malformations in the development of the lymphatic system. Furthermore, compared with routine cesarean section, the short-term maternal outcomes were not different with regard to infection rate, estimated blood loss, wound complication, and postpartum hospital stay. [Copyright &y& Elsevier]
- Published
- 2008
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77. Malignant cervical teratoma: report of a case in a newborn.
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Muscatello, Luca, Giudice, Marco, and Feltri, Maddalena
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TERATOMA , *NEWBORN infants , *CERVICAL cancer , *TUMORS , *CANCER treatment , *RESPIRATORY therapy for newborn infants , *AIRWAY (Anatomy) - Abstract
Malignant cervical teratoma (MCT) usually appears in newborns as an enlarging mass of the neck that causes respiratory distress, requiring prompt airway control. We report a case of MCT in an infant electively delivered at 32 weeks to prevent airway impairment. At first, the preoperative diagnosis was hygroma of the neck, and a surgical excision was performed when the newborn was 9 days old. Diagnosis was benign extragonadic immature teratoma, but it was changed in MCT when cervical metastases appeared and the alpha-fetoprotein (AFP) level increased. Subsequent surgical procedures and chemotherapy were necessary. The child has been free from disease and healthy for 7 years since the last surgery. The preoperative diagnosis of MCT is difficult because of its rarity and non-specific clinical findings. Surgical excision is required for an adequate cure and airway repair; a long-term follow-up is mandatory to promptly treat any recurrence. [ABSTRACT FROM AUTHOR]
- Published
- 2005
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78. Prenatal three-dimensional ultrasound and magnetic resonance imaging evaluation of a fetal oral tumor in preparation for the ex-utero intrapartum treatment (EXIT) procedure.
- Author
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Peng, S. S., Hsuf, W. C., Chou, H. C., Chen, L. K., Chang, Y. L., and Hsieh, F. J.
- Subjects
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FETAL ultrasonic imaging , *THREE-dimensional imaging , *MEDICAL imaging systems , *MAGNETIC resonance imaging , *TUMORS , *FETUS , *PREGNANCY - Abstract
Recent attempts at predelivery management of obstructed fetal airways have focused on the EXIT (ex-utero Intrapartum treatment) procedure, which allows sufficient time to secure the fetal airway through preservation of utero placental gas exchange. We report a fetus with an exophytic oral tumor noted at 34 weeks of gestation. In this case, three-dimensional (3D) ultrasound allowed a complete and interactive evaluation of the tumor and related facial anatomy, and confirmed that access to the fetal airway was unlikely during delivery. Fetal magnetic resonance imaging (MRI) further demonstrated that the upper originated in the nasopharynx and obstructed the upper airway. Both imaging results led to a final decision to offer an EXIT procedure for the neonate. At 36 weeks' gestation, a successful EXIT procedure was performed to reduce the risk of respiratory distress immediately after birth. This report highlights the value of 3D ultrasound and MRI as essential prerequisites for optimization of the triage process in selecting EXIT candidates. [ABSTRACT FROM AUTHOR]
- Published
- 2005
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79. Prenatal diagnosis of an epignathus: a case report and review of the literature.
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Clement, K., Chamberlain, P., Boyd, P., and Molyneux, A.
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TERATOMA , *ORAL diseases , *PALATE abnormalities , *ULTRASONIC imaging , *PREGNANCY complications - Abstract
AbstractAn epignathus is an extremely rare form of teratoma that arises from the oral cavity, most commonly from the palate. We describe a case identified sonographically at 17 weeks’ gestation after a raised maternal serum alpha-fetoprotein was recorded. This pregnancy was terminated but we review the literature over the last 10 years and describe the management options available in such cases. [ABSTRACT FROM AUTHOR]
- Published
- 2001
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80. The fatal fetal tumor: a geneticist's perspective
- Author
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Veronica Arora, Ratna Dua Puri, Seema Rao, Sunita Bijarnia Mahay, I. C. Verma, Chandra Mansukhani, Anisha Manocha, Ranjana Mishra, Nandita Dimri, and Seema Gupta
- Subjects
Fetus ,medicine.medical_specialty ,business.industry ,Obstetrics ,Perspective (graphical) ,High mortality ,Infant, Newborn ,Teratoma ,Obstetrics and Gynecology ,Autopsy ,Early neonatal period ,Geneticist ,Epignathus ,medicine.disease ,Ultrasonography, Prenatal ,Fetal Diseases ,Pregnancy ,Pediatrics, Perinatology and Child Health ,medicine ,Humans ,Female ,business ,Twins, Conjoined - Abstract
Epignathus is an extremely rare oral teratoma which leads to high mortality in the early neonatal period. Various theories have been put forward for the genesis of such a tumor, though none is completely convincing. A genetic basis is not well established for the tumor. Microdeletions/duplications, as well as single gene disorders, have been known to cause epignathus, all with additional malformations. Evidence of single gene involvement in an isolated epignathus is lacking. We present a case of a 19-week-fetus with oro-pharyngeal teratoma detected on the level II ultrasound. The couple was counseled regarding the grave prognosis of the fetal condition following which they opted for termination of pregnancy and fetal autopsy. The autopsy revealed fetus-like body attached to the tumor. Genetic testing including a whole genome microarray did not reveal any significant variant. An explanation for the fetus-like body maybe a common origin of the teratoma and the additional fetus-like bodies due to an erroneous process of early embryonic development. Another possibility is of an acardiacus acranius twin masquerading as a fetus-like body. Thus, we conclude that in the absence of an associated malformation, an epignathus is unlikely to have a genetic etiology. This study highlights the importance of performing a fetal autopsy as a part of deep phenotyping to ascertain the etiology, as it identified additional fetal-like body which was not detected on the antenatal ultrasound.
- Published
- 2019
81. An autopsy case of epignathus (immature teratoma of the soft palate) with intracranial extension but without brain invasion: case report and literature review
- Author
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Mitsuhisa Shinya, Ikumi Kitazono, Tsubasa Hiraki, Akira I. Hida, Akihide Tanimoto, Sohsuke Yamada, Mari Kirishima, Michiyo Higashi, Yuko Goto, and Shun Onishi
- Subjects
Epignathus ,Adult ,Pathology ,medicine.medical_specialty ,Histology ,Fossa ,Immature teratoma ,Autopsy ,Case Report ,Gestational Age ,Ultrasonography, Prenatal ,Pathology and Forensic Medicine ,03 medical and health sciences ,0302 clinical medicine ,Intracranial extension ,Pregnancy ,lcsh:Pathology ,medicine ,Humans ,Hypoxia ,030219 obstetrics & reproductive medicine ,medicine.diagnostic_test ,biology ,Soft palate ,business.industry ,Teratoma ,Magnetic resonance imaging ,030206 dentistry ,General Medicine ,Stillbirth ,biology.organism_classification ,medicine.disease ,Magnetic Resonance Imaging ,Tumor Burden ,Sella turcica ,medicine.anatomical_structure ,Female ,Mouth Neoplasms ,Palate, Soft ,business ,lcsh:RB1-214 - Abstract
Background Epignathus is a rare congenital orofacial teratoma infrequently associated with intracranial extension. Intracranial extension of an epignathus indicates a poor prognosis; however, only a small number of such cases have been reported. While there have been some studies reporting cases of epignathus expanding directly into the cranium, others have reported no communication between an epignathus and an intracranial tumor. Case presentation A fetus at gestational week 27 was suspected of having an epignathus with intracranial tumor as shown by ultrasonographic and magnetic resonance imaging. The fetus was stillborn and an autopsy was performed. An epignathus measuring 12 × 6 × 6 cm and weighing 270 g protruded from the mouth, with its base on the soft palate. An intracranial tumor weighing 14 g was located at the middle intracranial fossa and connected to the epignathus through the right side of the sella turcica. The intracranial tumor was encapsulated, and there was no invasion into the brain. Histologically, both the epignathus and intracranial tumor were immature teratomas, with neural and pulmonary components that were especially immature as compared to those of the internal organs and brain tissues of the fetus. Conclusion There have been several reports of epignathus and intracranial tumors that did not communicate; therefore, careful evaluation is needed when a fetus is suspected of having an epignathus extending into an intracranial lesion. Our case supports the findings that an epignathus can directly expand into the cranium. Moreover, this is a rare case of an epignathus in which the intracranial lesion was encapsulated and did not invade the brain. These rare but important findings will provide additional, potential therapeutic strategies for gynecologists, neurosurgeons, and pathologists.
- Published
- 2018
82. Tongue shaped oropharyngeal teratoma with cleft palate in a neonate: A case report
- Author
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Nadia Afroz, Jiaul Reza, and Samiul Hasan
- Subjects
Epignathus ,medicine.medical_specialty ,lcsh:Surgery ,Neonatal tumor ,03 medical and health sciences ,0302 clinical medicine ,Tongue ,Medicine ,Oropharyngeal teratoma ,business.industry ,lcsh:RJ1-570 ,lcsh:Pediatrics ,lcsh:RD1-811 ,030206 dentistry ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Cleft palate ,Pediatrics, Perinatology and Child Health ,Histopathology ,Teratoma ,Good prognosis ,Presentation (obstetrics) ,Abnormality ,business ,Airway ,030217 neurology & neurosurgery - Abstract
Background: Atypical presentation of an atypical abnormality makes the diagnosis challenging. Oropharyngeal teratoma (epignathus) is a rare, potentially life-threatening neonatal tumor. Its atypical presentation may cause a delay in diagnosis and increase morbidity and mortality. Case presentation: A newborn girl with oropharyngeal teratoma and cleft palate presented with feeding difficulty. The airway was patent. The tumor was tongue-shaped, smooth-walled, displacing the native tongue, and prevented the fusion of two palatine halves resulting in cleft palate. On the 4th day of life, complete excision was done transorally. Histopathology revealed a mature teratoma. There was no sign of recurrence at three months of follow-up. Conclusion: Presentation of the oropharyngeal teratoma varies according to its site, size, and extension. Timely diagnosis is essential to avoid life-threatening respiratory obstruction. Complete excision of the mass is usually associated with a good prognosis.
- Published
- 2021
83. Congenital immature teratomas. Two case reports
- Author
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A O Zolotukhina, E V Protsenko, S A Sharygin, and O P Saryeva
- Subjects
0301 basic medicine ,endocrine system ,Pathology ,medicine.medical_specialty ,endocrine system diseases ,Prenatal diagnosis ,urologic and male genital diseases ,Epignathus ,Pathology and Forensic Medicine ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Humans ,Medicine ,Retroperitoneal space ,neoplasms ,Fetus ,business.industry ,Teratoma ,Infant ,Stillbirth ,Prognosis ,medicine.disease ,female genital diseases and pregnancy complications ,030104 developmental biology ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Female ,Mouth Neoplasms ,Immature teratoma ,Germ cell tumors ,Live birth ,business - Abstract
Teratomas belong to a group of germ cell tumors and consist of tissues that are derived from 3 germ layers. The localization of teratomas is extremely diverse. The main task of a morphological study is to diagnose the type of teratoma. According to the WHO classification, there are mature and immature teratomas (ICD-O codes 9080/0 and 9080/3, respectively). It is deemed that the disease prognosis does not depend on the composition of mature tissue components. This paper describes two sectional observations of congenital immature teratomas in a premature live birth infant and a stillborn one. One teratoma, such as epignathus, is a very rare tumor in localization. Emphasis is laid on the need for a thorough teratoma morphological study that defines the tactics of patient management. The described observations demonstrate the importance of timely prenatal diagnosis and an interdisciplinary approach, as well as the need for clear routing of patients with diagnosed fetal space-occupying lesions.Тератомы относятся к группе герминогенно-клеточных опухолей и состоят из тканей, являющихся производными 3 зародышевых листков. Локализация тератом крайне разнообразна. Основной задачей морфологического исследования является диагностика вида тератомы. Согласно классификации ВОЗ, выделяют зрелые и незрелые тератомы (коды ICD-O9080/0 и 9080/3 соответственно). Считается, что прогноз заболевания не зависит от состава зрелых тканевых компонентов. В данной статье приводится описание 2 секционных наблюдений врожденных незрелых тератом у недоношенных живорожденного и мертворожденного, одна из которых эпигнатус — крайне редкая по локализации опухоль. Подчеркнута необходимость тщательного морфологического исследования тератом, определяющего тактику лечения пациентов. Описанные наблюдения демонстрируют важность своевременной пренатальной диагностики и междисциплинарного подхода, а также необходимость четкой маршрутизации пациентов с диагностированными объемными образованиями у плода.
- Published
- 2021
84. Epignathi Teratoma Co-Existing with Tongue Choristoma and Cleft Palate in a Neonate: Report of a Rare Case and Review of Literature
- Author
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Abba Zarami Bukar, Mohammed Adam Sheikh Abdullahi, Samuel Wapada, Hector Oladapo Olasoji, and Hamidu Umaru Pindiga
- Subjects
Pathology ,medicine.medical_specialty ,Choristoma ,business.industry ,030206 dentistry ,General Medicine ,Epignathus ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Tongue ,Rare case ,medicine ,Teratoma ,business ,030217 neurology & neurosurgery ,Large size - Abstract
Background: Oral epignathus teratoma is an extremely rare neoplasm that occurs exclusively in neonates. The tumor can grow to a large size obstructing airways and it may prevent fusion of the nasal septum with the palatine processes, which may result in cleft palate formation. The rare tumor may also co-exist with other congenital malformations such as hamartoma and choristoma causing airway obstruction and death. Case report: We present a case of a one-day-old male neonate who presented with oral mass associated with difficulty in breathing and inability to suck breast milk. Computed Tomography (CT) scan revealed multiple masses involving the alveolar, palate, and tongue along with cleft palate. Emergency surgery was done to relieve the airway and histology confirmed epignathi teratoma with tongue choristoma. Conclusion: Epignathus teratoma is a rare condition that requires prenatal prompt diagnosis. However, in countries with underprivileged hospital facilities, early surgical intervention during the neonatal period is what is required to save the patient from airway obstruction. Association of the tumor with midline anomalies is mostly the norms, however, 5% of cases with malignant transformation have been reported and the tumor is commonly associated with endodermal sinus tumor. Therefore long term follow-up of patients with serum tumor markers is highly recommended.
- Published
- 2020
85. Basicranial teratoma.
- Author
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Evrenkaya, T., Karaga, C., Erdogan, B., Aksoy, F., Pulat, H., and Akoz, T.
- Abstract
Teratomas are tumors formed by pluripotential primordial germ cells which constitute heterogeneous types of tissues foreign to the organ from which they originate. Rarely however, an extragonadal presentation occurs. Origin in the gonads is most common. An infant with an incomplete cleft palate, and a 20 × 10 × 10 cm mass protruding from the mouth is presented. The lesion had a pedicle 20 cm in length, its base being attached to the hard palate. Soon after birth, surgical excision was performed. Histopathological examination revealed a teratoma containing mature elements from all 3 germinal layers without evidence of malignant change. The pathogenesis and the prognosis of this rare tumor are reviewed. [ABSTRACT FROM AUTHOR]
- Published
- 1992
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86. Partielle Doppelanlage des Unterkiefers mit Epignathus, Zwischenkieferbürzel und Zungenspalte.
- Author
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Steinhilber, W.
- Abstract
Copyright of Zeitschrift für Kinderheilkunde is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 1972
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87. [Epignathus, the importance of prenatal diagnosis and interdisciplinary work: A case report].
- Author
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Parellada C, Pose MN, Vázquez Durand M, Rubies Y, Albas Maubett D, Saint Genez D, and Vidaurreta S
- Subjects
- Cesarean Section, Female, Gestational Age, Humans, Infant, Newborn, Pregnancy, Prenatal Diagnosis, Ultrasonography, Prenatal, Airway Obstruction, Teratoma
- Abstract
Thanks to technological advances, it has been possible to carry out the prenatal diagnosis of different life-threatening congenital malformations. Among these, oral teratoma, or epignathus, is a rare form of congenital teratoma within those located in the head and neck. They are generally benign and comprise 4 % of neonatal teratomas. From the development of the EXIT technique (ex utero intrapartum treatment), which has been implemented since the 90's to support fetal circulation until the newborn's airway is secured, it is possible to plan a multidisciplinary management strategy that enables the correct approach of these pathologies. We present a case of giant epignathus in a 35-week gestation female patient, whose airway was secured using the EXIT technique, and follow up., Competing Interests: None, (Sociedad Argentina de Pediatría.)
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- 2021
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88. Giant epignathus of the palate: a case report
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Marcelo P. Menezes Filho and Nábia Maria M. S. Simão
- Subjects
medicine.medical_specialty ,business.industry ,Risk of malignancy ,Clinical Biochemistry ,Congenital malformations ,teratoid severe abnormalities ,Epignathus ,medicine.disease ,Malignancy ,Complete resection ,Pathology and Forensic Medicine ,Surgery ,Medical Laboratory Technology ,medicine ,lcsh:Pathology ,Teratoma ,business ,teratoma ,anormalidades teratoides graves ,lcsh:RB1-214 - Abstract
Epignathi are congenital malformations, with a high level of mortality due to their obstructive mechanism and respiratory involvement. Most of them are benign; however, cases of malignant epignathus have been described. The possibilities of malignancy increase in the presence of neuroepithelium, an important confounding factor. Epignathus is described in a newborn, besides its clinical and histopathological study. Surgery with complete resection is the definitive treatment. Residual tissue is linked to recurrence, curiously without increasing the risk of malignancy.
- Published
- 2015
89. Malignant epignathus including a nephroblastoma component and successful management.
- Author
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Ince, E. Zeynep, Cekmez, Ferhat, Yıldırım, Şükran, Demirel, Atalay, Bilgic, Bilge, Kılıcaslan, Isın, and Coban, Asuman
- Subjects
TERATOMA ,NEPHROBLASTOMA ,INFANT boys ,PREGNANCY ,TRACHEOTOMY ,SURGICAL excision ,DISEASES ,THERAPEUTICS - Abstract
Abstract: A male infant was born to a 24-year-old mother (gravida 1 para 1) by cesarean delivery at 33 1/7 weeks of gestation. The physical examination revealed a large mass protruding from the baby''s mouth, which appeared to be attached to the palate. Tracheostomy was performed immediately in the delivery room. A partial surgical excision was performed on the second postnatal day, removing most of the teratoma (epignathus), which was attached to the back of the pharynx and protruding from the baby''s mouth measuring 13×11×9 cm and weighing 545 g. The final pathological diagnosis was “malignant epignathus with nephroblastoma component.” According to our knowledge, this is the first case that have malignant epignathus including nephroblastoma component in the literature. [Copyright &y& Elsevier]
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- 2013
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90. Early prenatal detection of a fast-growing fetal epignathus.
- Author
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Nagy, Gyula R., Neducsin, Bence P., Lázár, Levente, Stenczer, Balázs, Csapó, Zsolt, and Rigó Jr, János
- Subjects
- *
ABORTION , *PRENATAL diagnosis , *TERATOMA , *FACE , *POLYHYDRAMNIOS , *FETUS , *TUMORS ,ULTRASONIC imaging of fetus abnormalities ,PHARYNX tumors - Abstract
Epignathus is a rare congenital orofacial teratoma. We present a case of a fast-growing tumor, where early prenatal diagnosis was made and where fetopathological examination revealed the reason of the remarkable ultrasonographic signs and underlined the expected poor prognosis. Ultrasonographic examination at 18 weeks' gestation showed that there was a growing tumor protruding from the fetus's mouth. The fetal stomach could not be seen and extreme polyhydramnios was also detected. After counseling, the couple opted for a termination of pregnancy. Fetopathological examination showed that the tumorosus mass was not only protruding from the mouth, but also inexplicably grew downwards, was connected to the hard palate and the periosteum of the vertebral corpus, making an airway and esophageal obstruction, causing the ultrasonographic findings. Postnatal treatment and surgical removal of this tumor seemed to be impossible. In case of an early detection of a fast-growing fetal epignathus, pregnancy termination should be considered. [ABSTRACT FROM AUTHOR]
- Published
- 2012
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91. Oropharyngeal epignathus with partial facial duplication: report of a rare case
- Author
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M. Herath, Ruwan Duminda Jayasinghe, D.K. Dias, and B.S.M.S. Siriwardena
- Subjects
medicine.medical_specialty ,Epignathus ,03 medical and health sciences ,0302 clinical medicine ,030202 anesthesiology ,Gene duplication ,Rare case ,Conjoined twins ,medicine ,Humans ,Parasitic twin ,business.industry ,Mandible ,Infant, Newborn ,Teratoma ,030206 dentistry ,Anatomy ,medicine.disease ,Surgery ,Maxillofacial Abnormalities ,Otorhinolaryngology ,Maxilla ,Female ,Mouth Neoplasms ,Oral Surgery ,business - Abstract
Foetal oral teratoma or epignathus is a rare benign condition that originates in the oropharyngeal region. The term 'teratoma' refers to a mass composed of poorly organized tissues derived from each of the three germ layers. Epignathus may occur when one twin ceases development during gestation and becomes vestigial to the fully formed dominant twin. The reported incidence of epignathus is approximately 1:35,000 to 1:200,000 live births. A unique case of partial facial duplication with gross histological and radiological evidence of partial duplication of the facial elements and organs is presented herein. The affected newborn baby underwent urgent surgery due to breathing difficulties. The mass was excised successfully and the infant made an uneventful recovery. The resected specimen included two developing faces, each composed of a developing mandible and maxilla with developing tooth buds. Tissues from all three germ layers were present. In such cases, the treatment option is exclusively surgical, and complete resection is curative in most cases during the early neonatal period.
- Published
- 2017
92. Giant Epignathus Teratoma Discovered at Birth: A Case Report and 7-Year Follow-Up
- Author
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Roberto Menezes Bezerra Dias, Cassiano Francisco Weege Nonaka, Lélia Batista de Souza, Leão Pereira Pinto, Cassandra Teixeira Valle Elias, Rita de Cassia Simões Matheus, and Cyntia Helena Pereira de Carvalho
- Subjects
Male ,medicine.medical_specialty ,Prenatal care ,Epignathus ,Lesion ,03 medical and health sciences ,0302 clinical medicine ,newborn ,Complete regression ,medicine ,Humans ,Head and neck ,teratoma ,General Dentistry ,Fetus ,business.industry ,Infant, Newborn ,Teratoma ,030206 dentistry ,medicine.disease ,Surgery ,alpha-fetoprotein ,epignathus ,030220 oncology & carcinogenesis ,Mouth Neoplasms ,medicine.symptom ,business ,Alpha-fetoprotein ,Follow-Up Studies - Abstract
Teratomas are tumors composed by tissues derived from the three germ cell layers, and they are relatively uncommon in head and neck. The term epignathus has been applied to teratomas from the oropharynx. This paper reports the case of a giant epignathus teratoma discovered at birth, which was successfully managed and followed up for 7 years. A newborn boy presented a polypoid tumor mass exteriorizing through the mouth over a length of 9 cm, with some surface areas resembling skin and others exhibiting hair. Computed tomography showed that the mass arose deep from the left hemiface. Alpha-fetoprotein (AFP) levels were high (316,000 ng/mL). Surgery was performed and microscopic analysis confirmed the diagnosis of mature teratoma. Because of residual tumor and high AFP levels, the patient was submitted to chemotherapy, resulting in complete regression of the lesion and normalization of AFP levels. Surgical repair of a cleft palate was performed at 5 years of age. At 7 years of age, the patient was in good general health and showed no clinical signs of recurrence. Although epignathus is a rare condition, it should be diagnosed in the fetus as early as possible. Prenatal care provides unquestionable benefits, providing the early diagnosis of anomalies that can jeopardize the life of the fetus and contributing to the indication of cases that require treatment before birth. Resumo Teratomas são tumores constituídos por tecidos derivados das três camadas de células germinativas e são relativamente incomuns em cabeça e pescoço. O termo epignathus tem sido utilizado para designar teratomas que se originam na orofaringe. Este artigo relata o caso de um teratoma epignathus gigante descoberto ao nascimento, o qual foi tratado com sucesso e proservado por 7 anos. Um menino recém-nascido apresentou uma massa tumoral polipoide que se exteriorizava através da boca por uma extensão de 9 cm, com regiões da superfície semelhantes à pele e outras exibindo pelos. Exame de tomografia computadorizada revelou que a massa se originava profundamente na hemiface esquerda. Os níveis de alfa-fetoproteína (AFP) se apresentavam elevados (316.000 ng/mL). Foi realizada cirurgia e a análise microscópica confirmou o diagnóstico de teratoma maduro. Por apresentar lesão residual e altos níveis de AFP, o paciente foi submetido à quimioterapia, resultando em regressão completa da lesão e normalização dos níveis de AFP. Correção cirúrgica de uma fenda palatina foi realizada aos 5 anos de idade. Aos 7 anos de idade, o paciente apresentava um bom estado de saúde geral, sem sinais clínicos de recorrência da lesão. Embora o epignathus seja uma condição rara, seu diagnóstico no feto deve ser realizado o mais precocemente possível. O cuidado pré-natal proporciona benefícios inquestionáveis, permitindo o diagnóstico precoce de anomalias que podem comprometer a vida do feto e contribuindo para a indicação de casos que requerem tratamento antes do nascimento.
- Published
- 2017
93. Epignathus Leading to Fatal Airway Obstruction in a Neonate
- Author
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Sushma Malik, Vivek Kishor Shah, Charusheela Sujit Korday, Shruti Sudhir Jadhav, and Shilpa Kapil Lad
- Subjects
Nasal cavity ,medicine.medical_specialty ,endocrine system diseases ,Clinical Biochemistry ,lcsh:Medicine ,Epignathus ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Biopsy ,medicine ,030212 general & internal medicine ,neoplasms ,cleft palate ,medicine.diagnostic_test ,business.industry ,lcsh:R ,Paediatrics Section ,General Medicine ,Airway obstruction ,medicine.disease ,Skull ,medicine.anatomical_structure ,congenital teratoma ,oropharyngeal teratoma ,Hard palate ,Radiology ,Teratoma ,business ,Calcification - Abstract
Teratomas are benign tumours containing cells from ectodermal, mesodermal and endodermal layers with an incidence of about 1 in every 4,000 births. Their commonest site is sacro-coccygeal region, followed by anterior mediastinum. The incidence of teratomas localised to the head and neck region is around 2–9% of all cases. Epignathus is a rare congenital oropharyngeal teratoma originating from the base of the skull. Here we present a rare case of oropharyngeal teratoma in a neonate who was referred to our institute with an ill-defined oral mass protruding through a cleft in the hard palate. Computed tomography scan showed a contrast-enhanced solid mass with areas of calcification and fat extending to oropharynx and nasal cavity with hard palate defect suggestive of a teratoma. Unfortunately, the patient succumbed due to respiratory compromise before the biopsy could be done. Postmortem histopathological examination confirmed diagnosis of benign teratoma consisting of mature tissue.
- Published
- 2017
94. Cleft palate associated with cervico-facial teratoma: Report of two cases and review of the literature
- Author
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Le Saux, A., Merol, M.L. Poli, Zachar, D., Josset, P., Pezzettigotta, S., Fenzy, M. Doco, Guyot, E., and Francois-Fiquet, C.
- Subjects
- *
CLEFT palate , *ORAL cancer , *LITERATURE reviews , *HISTOPATHOLOGY , *TERATOMA , *EMBRYONAL tumors , *TUMORS in children - Abstract
Abstract: We report two original cases of association of cleft palate and lateral cervico-facial teratoma. We discuss the embryological explanation. The first child presented a cleft palate associated with two cervico-facial localisations of teratoma. The other had Pierre Robin sequence associated with lateropharyngeal teratoma with an extra sub maxillary localisation. Most reported cases were of midline teratomas, leading different authors to advance a mechanical origin to the cleft. Our cases are different: we could hardly find reported cases of associate lateral tumours and cleft palate, which would suggest two different embryologic mechanisms, or at least a combination of more complicated phenomenons. [Copyright &y& Elsevier]
- Published
- 2012
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95. Congenital large maxillary teratoma.
- Author
-
Ram, Hari, Rawat, J. D., Devi, Seema, Singh, Nimisha, Paswan, Vimlesh Kr., and Malkunje, Laxman R.
- Abstract
Teratoma of the maxilla is a rare entity. Congenital intraoral teratoma occurs in 1:4000 births. It is a benign tumor, although malignancy has been described in adults. A 10-year-old male child with this condition is described in this report. This case illustrates a huge mass on the right side of the maxilla. The mass was excised under general anesthesia. Histopathologically, it consisted of all three layers of embryonic elements with predominantly fibrous tissue. Postoperative result was uneventful and no recurrence was detected after 2 years. [ABSTRACT FROM AUTHOR]
- Published
- 2012
- Full Text
- View/download PDF
96. Prenatal Diagnosis of a Large Epignathus Teratoma Using Two-Dimensional and Three-Dimensional Ultrasound: Correlation with Pathological Findings
- Author
-
Edward Araujo Júnior, Antonio Fernandes Moron, C.L. Drummond, José Mendes Aldrighi, L. C. S. Bussamra, Luciano Marcondes Machado Nardozza, Sandra Regina Silva Herbst, and Maira Mariko Takagi
- Subjects
medicine.medical_specialty ,Adolescent ,Prenatal diagnosis ,Epignathus ,Ultrasonography, Prenatal ,Bifid tongue ,Fatal Outcome ,Imaging, Three-Dimensional ,Humans ,Medicine ,Nose ,Fetus ,business.industry ,Pharynx ,Infant, Newborn ,Teratoma ,Anatomy ,Prognosis ,medicine.disease ,Rathke's pouch ,Fetal Diseases ,Oropharyngeal Neoplasms ,medicine.anatomical_structure ,Otorhinolaryngology ,Female ,Radiology ,Oral Surgery ,business - Abstract
Epignathus teratomas are rare tumors that originate in the region of the palate or pharynx and are known as Rathke pouch. They may be associated with other malformations such as a cleft palate and bifid tongue or nose. The prenatal diagnosis can be established by two-dimensional ultrasonography showing a heterogeneous mass protruding through the mouth of the fetus. The three-dimensional ultrasonography in rendering mode permits better understanding of this anomaly by the parents, facilitating the counseling. The importance of prenatal diagnosis lies in the fact that this tumor may obstruct the airways, thus leading to death at birth due to respiratory insufficiency. We report a case of prenatal diagnosis of epignathus teratoma in the 30th week of pregnancy by two-dimensional ultrasonography. We focus on the importance of three-dimensional ultrasonography in rendering mode for demonstrating the spatial relationships of the tumor with the oral cavity and provide correlations between the ultrasound images and the anatomopathological findings.
- Published
- 2014
97. A case report of nasopharyngeal teratoma with a cleft palate and an inguinal hernia.
- Author
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Pasupathy, M., Narayanan, P.V., Mani, Varghese, and Adenwalla, H.S.
- Subjects
NASOPHARYNX tumors ,TERATOMA ,CLEFT palate ,INGUINAL hernia ,OBSTRUCTIVE lung diseases ,EDEMA ,PLASTIC surgery - Abstract
Summary: Nasopharyngeal teratoma is a rare teratoma arising anywhere from the oronasal cavity, regarded as an expanding, cavity-filling lesion, with a high mortality rate due to severe airway obstruction, especially in the neonatal period. We report a patient with a single, firm, hairy swelling arising from vomer, protruding into the oral cavity associated with cleft palate and an inguinal hernia. Excision of the lesion and reconstruction of the cleft palate was successfully performed in a single stage. To the best of our knowledge, this is the first report of a child with a nasopharyngeal teratoma, cleft palate and an inguinal hernia. [ABSTRACT FROM AUTHOR]
- Published
- 2011
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98. Malignant Epignathus with Intra Cranial Extension: A Very Unusual Case
- Author
-
Aynur Mustafa
- Subjects
Unusual case ,Extension (metaphysics) ,business.industry ,Medicine ,Anatomy ,Epignathus ,business - Published
- 2016
99. Surgical Management of Duplication of the Pituitary Gland-Plus Syndrome With Epignathus, Cleft Palate, Duplication of Mandible, and Lobulated Tongue
- Author
-
Kosaku Maeda, Kenichi Sasaguri, Tadahide Noguchi, Tomoko Sugiyama, Yoshiyuki Mori, Hiroshi Nishino, Shigeru Ono, and Yoshinori Jinbu
- Subjects
Male ,Palate, Hard ,medicine.medical_treatment ,Palatal Neoplasms ,Mandible ,Epignathus ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,stomatognathic system ,Tongue ,medicine ,Alveolar ridge ,Humans ,Abnormalities, Multiple ,Soft palate ,business.industry ,Infant, Newborn ,Teratoma ,Infant ,General Medicine ,Anatomy ,Syndrome ,Lip ,Cleft Palate ,medicine.anatomical_structure ,Palatoplasty ,Otorhinolaryngology ,Child, Preschool ,Pituitary Gland ,Surgery ,Hard palate ,Palate, Soft ,business ,030217 neurology & neurosurgery - Abstract
A 1-day-old male infant was referred to our department for evaluation of multiple malformations in his oral cavity. He was diagnosed duplication of the pituitary gland-plus syndrome with epignathus, cleft palate, duplication of the mandible, and a lobulated tongue. A thumb-sized mass lesion was visible on the hard palate. The duplicated mandible and lower lip was fused at the midline. The alveolar ridge was protruding through a wide-cleft soft palate involving the uvula. Further examination showed a lobulated tongue, which was seen behind the duplicated part of the mandible. Five days after birth, tracheotomy and epignathus resection were performed. At 7 months of age, the excess tissue of the duplicated mandible was resected at the area of adhesion on the lingual side, and the duplicated tongue and lip were reconstructed. A palatoplasty was performed at 20 months of age. Thereafter, the patient's progress was uneventful, with no abnormality in swallowing. No recurrence of epignathus has been observed during 2 years of follow-up.
- Published
- 2016
100. Blue Rubber Bleb Nevus Syndrome Diagnosed Prenatally as an Epignathus
- Author
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Anna Kucińska-Chahwan, Aneta Kalcowska, Michał Ciebiera, Tomasz Roszkowski, Włodzimierz Piwowar, and Grzegorz Jakiel
- Subjects
Adult ,Male ,medicine.medical_specialty ,Skin Neoplasms ,Epignathus ,Ultrasonography, Prenatal ,Diagnosis, Differential ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,030225 pediatrics ,Nevus, Blue ,Medicine ,Nevus ,Humans ,Tongue Neoplasm ,Blue nevus ,Gastrointestinal Neoplasms ,Fetus ,030219 obstetrics & reproductive medicine ,business.industry ,Cesarean Section ,Infant, Newborn ,General Medicine ,medicine.disease ,Blue rubber bleb nevus syndrome ,Surgery ,Tongue Neoplasms ,Fetal Diseases ,Otorhinolaryngology ,Female ,Differential diagnosis ,Presentation (obstetrics) ,medicine.symptom ,business - Abstract
The authors present a clinical report of the giant fetal tumor protruding from the oral cavity diagnosed sonographically at 32 weeks of gestation as an epignathus. After delivery, tumor proved to be a presentation of the blue rubber bleb nevus syndrome. To the best of our knowledge, the literature offers no reports on similar cases.
- Published
- 2016
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