Vol 88, No 5 (2017)
Review paper
Published online: 2017-05-31
Fetal neck tumors – antenatal and intrapartum management
Abstract
In this review article we describe the ante- and perinatal management of fetal neck tumors. Although there are rare congenital anomalies, the clinical consequences for the fetus may be fatal and include airways obstruction, heart insufficiency, pulmonary hypoplasia and cosmetic effect. The right management allows to decrease the fetal and neonatal mortality and morbidity associated with the disease. It includes intrauterine therapy in some cases, mostly in a goitrus hypothyroidism of the fetus, but firstly, an assessment of the fetal airways patency with a subsequent, eventual Ex-Utero Intrapartum Treatment (EXIT).
Keywords: fetusneck tumorsultrasoundairways obstructionEx-Utero Intrapartum Treatment
References
- Keswani SG, Crombleholme TM. Fetal tumors: clinical management. In: Kilby MD, Oepkes D, Johnson A. ed. Fetal Therapy Scientific Basis and Critical Appraisal of Clinical Benefits. Cambridge 2013: 329–340.
- Wolfe K, Lewis D, Witte D, et al. Fetal cervical teratoma: What is the role of fetal MRI in predicting pulmonary hypoplasia? Fetal Diagn Ther. 2013; 33(4): 252–256.
- Kornacki J, Mroziński B, Skrzypczak J. A rare case of recurrent fetal goiter. Fetal Diagn Ther. 2012; 31(1): 69–72.
- Abuhamad AZ, Fisher DA, Warsof SL, et al. Antenatal diagnosis and treatment of fetal goitrous hypothyroidism: case report and review of the literature. Ultrasound Obstet Gynecol. 1995; 6(5): 368–371.
- Perrotin F, Sembely-Taveau C, Haddad G, et al. Prenatal diagnosis and early in utero management of fetal dyshormonogenetic goiter. Eur J Obstet Gynecol Reprod Biol. 2001; 94(2): 309–314.
- Grüner C, Kollert A, Wildt L, et al. Intrauterine treatment of fetal goitrous hypothyroidism controlled by determination of thyroid-stimulating hormone in fetal serum. A case report and review of the literature. Fetal Diagn Ther. 2001; 16(1): 47–51.
- Simsek M, Mendilcioglu I, Mihci E, et al. Prenatal diagnosis and early treatment of fetal goitrous hypothyroidism and treatment results with two-year follow-up. J Matern Fetal Neonatal Med. 2007; 20(3): 263–265.
- Mayor-Lynn KA, Rohrs HJ, Cruz AC, et al. Antenatal diagnosis and treatment of a dyshormonogenetic fetal goiter. J Ultrasound Med. 2009; 28(1): 67–71.
- Hanono A, Shah B, David R, et al. Antenatal treatment of fetal goiter: a therapeutic challenge. J Matern Fetal Neonatal Med. 2009; 22(1): 76–80.
- Ribault V, Castanet M, Bertrand AM, et al. French Fetal Goiter Study Group. Experience with intraamniotic thyroxine treatment in nonimmune fetal goitrous hypothyroidism in 12 cases. J Clin Endocrinol Metab. 2009; 94(10): 3731–3739.
- Singh PK, Parvin CA, Gronowski AM. Establishment of reference intervals for markers of fetal thyroid status in amniotic fluid. J Clin Endocrinol Metab. 2003; 88(9): 4175–4179.
- Baumann NA, Gronowski AM. Establishment of reference intervals for thyroid- stimulating hormone and free thyroxine in amniotic fluid using the Bayer ADVIA Centaur. Am J Clin Pathol. 2007; 128(1): 158–163.
- Mikovic Z, Simic R, Egic A, et al. Intrauterine treatment of large fetal neck lymphangioma with OK-432. Fetal Diagn Ther. 2009; 26(2): 102–106.
- Neck lymphangioma: intracystic injection of OK-432. 12th World Congress in Fetal Medicine. Marbella,Spain, June 23-27/2013.
- Hirose S, Sydorak RM, Tsao K, et al. Spectrum of intrapartum management strategies for giant fetal cervical teratoma. J Pediatr Surg. 2003; 38(3): 446–50; discussion 446.
- Lazar DA, Cassady CI, Olutoye OO, et al. Tracheoesophageal displacement index and predictors of airway obstruction for fetuses with neck masses. J Pediatr Surg. 2012; 47(1): 46–50.
- Cruz-Martinez R, Moreno-Alvarez O, Garcia M, et al. Fetal Endoscopic Tracheal Intubation: A New Fetoscopic Procedure to Ensure Extrauterine Tracheal Permeability in a Case with Congenital Cervical Teratoma. Fetal Diagn Ther. 2015; 38(2): 154–158.
- Özgünen FT, Güleç ÜK, Evrüke İC, et al. Fetal Oropharyngeal and Neck Tumors: Determination of the Need for Ex-Utero Intrapartum Treatment Procedure. Balkan Med J. 2015; 32(2): 221–225.
- Laje P, Johnson MP, Howell LJ, et al. Ex utero intrapartum treatment in the management of giant cervical teratomas. J Pediatr Surg. 2012; 47(6): 1208–1216.
- Helfer DC, Clivatti J, Yamashita AM, et al. Anesthesia for ex utero intrapartum treatment (EXIT procedure) in fetus with prenatal diagnosis of oral and cervical malformations: case reports. Rev Bras Anestesiol. 2012; 62(3): 411–423.
