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  • Imaging Casebook
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Imaging Case Book

Cervical teratoma

Journal of Perinatology volume 28, pages 649–651 (2008)Cite this article

A large anterior almost midline cervical mass of heterogeneous intensity, which was compressing the cervical trachea, was noted on the fetal magnetic resonance imaging. The mass extended into the upper anterior mediastinum. This was believed to represent either a cervical (cervicothymic) teratoma or a hemangio-lymphangioma. Because of the tracheal compression, the extrauterine intrapartum therapy was planned for the delivery. The findings were confirmed on the postnatal sonogram, which demonstrated a heterogeneous cervical mass extending to the level of the superior aspect of the thymus. At resection, the mass was attached to the thymus, which was delivered into the neck in order, and was easily separated from the mass. At histological examination, the mass was an immature teratoma containing pancreatic tissue, intestinal tissue and brain tissue.

A teratoma is a tumor composed of all three germ cell layers; ectoderm, mesoderm and endoderm. Cervical teratoma is a rare congenital tumor with a poor prognosis and a nearly 100% mortality if not immediately managed and resected.1 The most common location of congenital teratomas is the sacro-coccygeal region; however, the head and neck is the second most common site.1 Head and neck teratomas are primarily cervical teratomas and oropharyngeal teratomas, referred to as epignathi.2 Among patients with sacro-coccygeal teratomas and epignathi, there is a distinct female predominance. Interestingly, this is not the case among patients with cervical teratomas.2 Stillbirth and oral airway obstruction are common problems with cervical teratomas. A stillbirth frequency of 17% and an airway compression frequency of 35% have been reported in infants with cervical teratoma.1 Polyhydramnios occurs in approximately 30%, probably secondary to esophageal obstruction. Very large or giant cervical teratomas may even result in fetal hydrops.

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  1. Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis Children's Hospital, St Louis, MO, USA

    T E Herman & M J Siegel

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  1. T E Herman
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  2. M J Siegel
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Correspondence to T E Herman.

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Herman, T., Siegel, M. Cervical teratoma. J Perinatol 28, 649–651 (2008). https://doi.org/10.1038/jp.2008.84

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