Children's Hospital Colorado

Cervical Teratoma

A cervical teratoma is a rare tumor that develops around the neck of a fetus and may vary in consistency and size. These growths are usually benign, though can be cancerous in some cases.

The main concern with a cervical teratoma is obstruction of the baby's airway and esophagus, resulting in the accumulation of fluid that can affect growth and even result in preterm delivery.

At the Colorado Fetal Care Center, we work with families who've recently found out their baby has a cervical teratoma. From your first visit with our fetal experts to the day you deliver your baby, we'll use our advanced diagnostics and state-of-the-art facility to provide the best treatment in the region.

A cervical teratoma is a large tumor that develops in the neck of a baby. These masses are an extremely rare form of a germ cell tumor and they are usually benign (non-cancerous).

There are no known genetic connections to the formation of cervical teratomas. While they're the second most common form of fetal neck mass, there are only 150 cases reported.

Cervical teratomas can complicate a baby's development by blocking or narrowing his or her airway. The tumor can also compress the esophagus, making it difficult or impossible for your baby to swallow amniotic fluid, which can lead to polyhydramnios, or excess fluid in the amniotic sac. This, in turn, may lead to preterm delivery.

Cervical teratomas are equally dangerous after birth, since the obstruction of the airway may prevent the baby from breathing or delay the ability to secure the airway at birth. As a result, it's important to develop a delivery treatment plan soon after receiving a cervical teratoma diagnosis.

A fetal cervical teratoma is almost always discovered through a routine ultrasound. These masses are large, asymmetrical and have clearly demarcated lines. A diagnosis is usually obtained through additional ultrasounds or a fetal MRI. An MRI is helpful in defining the degree of airway distortion, which can help your fetal care team create a treatment plan during your pregnancy as well as immediately after birth.

While a cervical teratoma diagnosis is certainly stressful for you and your family, several treatment options have proven successful. Our fetal and pediatric surgery team has made great strides in the advancement of care and treatment for this condition.

The Colorado Fetal Care Center is one of the leading care centers for babies diagnosed with a cervical teratoma, and we’ve treated more than 35 patients with these masses. Depending on the size and severity of the mass, our team will develop a treatment plan that may include observation, in-utero procedures, EXIT procedures and postnatal treatments.

Observation

Observation is one of the treatment options for small cervical teratomas with no risk of airway obstruction or high output cardiac failure. These cases are usually followed during pregnancy with ultrasounds. Once the baby is born, definitive anatomical detail is obtained by CT scans and consultations with our multidisciplinary team of experts.

Aspiration of dominant cysts

Aspiration of cysts, or removal of fluid using a needle, is another option available for certain cervical teratomas with a dominant large cyst at risk of obstruction or rupture. Aspiration of the cyst contents will relieve the pressure temporarily, then ultrasounds will be used until delivery to monitor the cyst.

EXIT procedure

The EXIT procedure is a special delivery technique where the head and neck of a baby are exposed through a limited incision in the uterus while maintaining pregnancy. Then, a breathing tube is placed, the cord is clamped and the baby is delivered. This technique allows the airway to be secured so the baby can transition normally from the womb, and provides an opportunity to perform resection of the mass. In some cases, a staged approach may be used to reduce the size of a mass until more imaging can be provided to plan for definitive removal.


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