Teratomas arising from the palate or pharynx may cause immediate life-threatening airway obstruction to the newborn. Early diagnosis via antenatal ultrasound enables the treating team to perform an ex utero intrapartum treatment (EXIT) procedure to secure an airway and perform subsequent tumour resection. We present the first EXIT procedure done in Malaysia. A 34 year old , gravida 4, para 3, her unborn child diagnosed at 24 weeks of gestation to have a large oropharyngeal mass. Upper airway obstruction was anticipated. Orchestration of multiple specialities was executed to properly plan and perform the EXIT procedure. The fetus was delivered at 33 weeks of gestation and managed to be intubated. The extraoral portion of the multilobular mass originating from the palate was resected. Complete resection of the intraoral teratoma was successfully done at day 22 of life.

Synovial sarcoma is a rare soft tissue sarcoma of the head and neck region involving the parapharyngeal space. The diagnosis of synovial sarcoma can be very challenging to the pathologists. We present a rare case of parapharyngeal synovial sarcoma in a young female patient who had a two-month history of left cervical intumescent mass at level II. The fine needle aspiration cytology of the mass was proved inconclusive. Transcervical excision of the mass was performed and the first case of parapharyngeal sarcoma was identified in our center by fluorescence in situ hybridization (FISH) technique. Repeat imaging revealed residual tumor. The patient successfully underwent a second excision of the residual tumor and received adjuvant radiotherapy.
Adult ; Biopsy, Fine-Needle ; Combined Modality Therapy ; Female ; Humans ; In Situ Hybridization, Fluorescence ; Neoplasm, Residual ; Pharyngeal Neoplasms ; diagnosis ; pathology ; radiotherapy ; surgery ; Radiotherapy, Adjuvant ; Sarcoma, Synovial ; diagnosis ; pathology ; radiotherapy ; surgery ; Tomography, X-Ray Computed