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Radiology
Neck Teratoma
Built from Obstetric Imaging
What’s inside
8 sections · 85 slides
Overview
- What this topic covers
- The story in one slide
What a neck teratoma is
Definition, how often, and what the tumour is made of
- Tumours before birth are rare
- What the word teratoma actually means
- The three sheets a teratoma is built from
- Benign does not mean harmless here
- 1.7-13.5
- Reading those numbers
- Who it happens to
- Why a fetal tumour is not a small adult tumour
- Where in the neck it starts
- What is inside the lump
- Immature tissue is not the same as cancer
How it comes to attention
The routine scan, the extra fluid, and why swallowing is the link
- How the diagnosis is usually made
- Why the fluid builds up
- The swallowing loop, explained
What ultrasound shows
The key sign, the calcifications, the blood flow, and the airway check
- When it can be seen
- The single most useful sign
- Solid neck mass on second-trimester ultrasound
- What to notice on that image
- The look of the tumour itself
- The finding that clinches it
- Giant cervical teratoma with bright calcified specks
- Reading the cross-section
- How far the tumour reaches
- Neck teratoma reaching inside the skull
- What to notice on the intracranial view
- When the tumour forces the head back
- Neck forced backwards with excess amniotic fluid
- What to notice on the side view
- Why the extra fluid signals danger
- The tumour's blood supply
- What colour Doppler adds
- Colour Doppler showing a densely vascular neck mass
- What to notice on the Doppler image
- Checking the airway before birth
- Straight midline trachea in a fetus with a neck mass
- What to notice on the trachea view
- Indirect clues that the windpipe is squeezed
- Signs pointing to tracheal compression
- What three-dimensional ultrasound adds
- Three-dimensional surface view of the neck mass
- What to notice on the 3D view
- Other abnormalities to look for
- A rare but serious complication
Magnetic resonance imaging
The second look that maps the tumour and the airway
- What magnetic resonance imaging adds
- Magnetic resonance image of a fetal neck mass
- What to notice on the MRI
- The question MRI is really asked
Look-alike neck masses
Telling a teratoma from the other lumps that sit in the fetal neck
- The three main look-alikes
- Sorting the main neck masses
- Lymphangioma
- Fluid-filled cystic mass in the fetal neck
- What to notice on the cystic mass
- Cystic hygroma
- Septated cystic swelling behind the fetal neck
- What to notice on the hygroma view
- Haemangioma
- Two mostly cystic, two with heavy flow
- The longer list of neck lumps
- The longer list, continued
Treatment before and after birth
No fetal surgery, but a delivery plan that changes survival
- What can be done before birth
- Planning the birth
- How an EXIT delivery runs
- Why EXIT is worth the trouble
- What can still go wrong
- Newborn with a giant neck mass, intubated after delivery
- What to notice in the newborn photograph
- An alternative to EXIT
- A practical problem at caesarean
- Surgery after birth
- What removing a very large tumour involves
- Glands that can be lost with the tumour
- Two risks that persist after a good start
Bringing it together
What the referring doctor needs, and the points worth remembering
- >80%
- What the referring physician needs to know
- Key points to carry away
- The imaging checklist
- From scan to safe birth
- References
- References (continued)
- References (continued)
- References (continued)
- Suggested readings
- Obstetric Imaging: Fetal Diagnosis and Care, 2nd Edition