Antenatal diagnosis and perinatal management of extremely giant fetal cervicopharyngeal teratoma resulting in impossible fetal intubation: A case report

We report the case of an extremely large giant neck teratoma diagnosed on routine sonogram and confirmed by 3-D and 4-D sonography and MRI in a 19-year-old primigravida at 18 weeks. Rapid growth, polyhydramnios, premature contractions and premature rupture of membranes necessitated delivery at 28 weeks. Under general anesthesia, with a multidisciplinary team attendant, efforts by the otolaryngologist to establish an airway during an EXIT (ex utero intrapartum treatment) procedure failed as did subsequent attempts by the neonatologist, leading to an early neonatal death. Although a team approach will increase the likelihood of success in securing the airway during EXIT procedures, it cannot be a guarantor in cases of giant neck teratoma.