PURPOSE: Congenital pulmonary airway malformation (CPAM)—a rare developmental anomaly—affects the lower respiratory tract in newborns. By comparing the reliability of diagnostic tools and identifying predictive factors for symptoms, we provide comprehensive clinical data for the proper management of CPAM. METHODS: We reviewed the medical records of 66 patients with prenatally diagnosed CPAM delivered at Severance Children's Hospital between January 2005 and July 2017. RESULTS: We enrolled 33 boys and 33 girls. Their mean gestational age and birth weight were 38.8 weeks and 3,050 g, respectively. Prenatal ultrasonography and postnatal radiography, lung ultrasonography, and chest computed tomography (CT) showed inconsistent findings. Chest CT showed superior sensitivity (100%) and positive predictive value (90%). Among the 66 patients, 59 had postnatally confirmed CPAM, three had pulmonary sequestration, one had cystic teratoma, and one had a normal lung. Of the 59 patients with CPAM, 21 (35%; mean age, 23.4 months) underwent surgery, including 15 who underwent video-assisted thoracoscopy. Twenty-five and 12 patients exhibited respiratory symptoms at birth and during infancy, respectively. Apgar scores and mediastinal shift on radiography were significantly associated with respiratory symptoms at birth. However, none of the factors could predict respiratory symptoms during infancy. CONCLUSION: Radiography or ultrasonography combined with chest CT can confirm an unclear or inconsistent lesion. Apgar scores and mediastinal shift on radiography can predict respiratory symptoms at birth. However, symptoms during infancy are not associated with prenatal and postnatal factors. Chest CT combined with periodic symptom monitoring is important for diagnosing and managing patients with prenatally diagnosed CPAM and to guide appropriate timing of surgery.
Birth Weight ; Bronchopulmonary Sequestration ; Cystic Adenomatoid Malformation of Lung, Congenital ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Lung ; Medical Records ; Parturition ; Radiography ; Respiratory System ; Teratoma ; Thoracic Surgery, Video-Assisted ; Thoracoscopy ; Thorax ; Tomography, X-Ray Computed ; Ultrasonography ; Ultrasonography, Prenatal

Dermoid cysts or mature cystic teratoma are the most common type of ovarian germ cell tumor. It may be complicated by torsion, rupture, chemical peritonitis and malignant change but is rarely complicated by infection. We present a case of an ovarian dermoid cyst with super-infection caused by Schistosoma haematobium (S. haematobium). We present here a case of incidental finding of S. haematobium eggs in an infected cystic teratoma of the ovary because of the rare occurrence of this lesion. A 45-year-old Moroccan woman admitted to the gynecological department because of abdominal pain and fever. Gynecological examination, ultrasonography, and abdominopelvic computed tomography scan revealed an ovarian mass thought to be a dermoid cyst. The pathological evaluation suggested infected ovarian dermoid cyst with the presence of adult worm in the tumor, contains same eggs of S. haematobium. Super-infection of an ovarian dermoid cyst is a rare event, and the association with S. haematobium is extremely rare in the literature.
Abdominal Pain ; Adult ; Dermoid Cyst* ; Eggs ; Female ; Fever ; Gynecological Examination ; Humans ; Incidental Findings ; Middle Aged ; Neoplasms, Germ Cell and Embryonal ; Ovary ; Ovum ; Peritonitis ; Rupture ; Schistosoma haematobium ; Teratoma ; Ultrasonography

Neuroblastoma is the most common pediatric extracranial solid tumor derived from primitive neural crest cells of the sympathetic nervous system. Although one-fifths of all neuroblastomas occurs within the thorax, thoracic neuroblastomas detected in fetus have been rarely reported. We report a case of fetal thoracic neuroblastoma with massive pleural effusion detected with prenatal ultrasonography. A 34-year-old Korean second-gravida was referred to our hospital at 30 weeks of gestation for evaluation, after the right lung mass found in the fetus. Approximately 3 cm, well-defined, hyperechoic mass was found in the right thorax with right pleural effusion, with the initial suspicion of teratoma. However, as mass continued to grow with deteriorating pleural effusion and fetal hydrops, the mass was considered malignant after 3 weeks. After a cesarean delivery, an approximately 4 cm mass with peripheral calcification and hemothorax was found on neonatal ultrasonography. Neuroblastoma was diagnosed on excision biopsy.
Adult ; Biopsy ; Fetus ; Hemothorax ; Humans ; Hydrops Fetalis ; Lung ; Mediastinum ; Neural Crest ; Neuroblastoma* ; Pleural Effusion ; Pregnancy ; Sympathetic Nervous System ; Teratoma ; Thorax ; Ultrasonography ; Ultrasonography, Prenatal

Benign teratomas of the thyroid are very rare in adolescence and adults. In this review, we report a case of 14-year-old Korean girl with huge neck mass. She presented with anterior neck enlargement and compression symptom which was rapidly aggravated in 2 months. In physical examination, enlarged and firm right thyroid lobe was palpated and laboratory test of thyroid function was normal. In ultrasonography, right lobe was mainly occupied with a solid nodule size of 44×23×25 mm, showing markedly inhomogeneous hypoechogenicity. As fine needle aspiration cytology was non-diagnostic, lobectomy was done. Histological examination demonstrated that the tumor is benign thyroid teratoma composed of tissue from all three germ layers. When large thyroid nodule is detected in adolescence and malignancy could not be ruled out, final diagnosis should be made with surgical resection. And we should at least attentive for possibility of teratomas when ultrasonographic findings are suspicious.
Adolescent* ; Adult ; Biopsy, Fine-Needle ; Diagnosis ; Female ; Germ Layers ; Humans ; Neck ; Physical Examination ; Teratoma* ; Thyroid Gland* ; Thyroid Nodule ; Ultrasonography

Autoamputated ovary with mature cystic teratoma (MCT) is a rarely reported gynecologic entity with an unknown prevalence. A 34-year-old woman referred to our clinic for presumed left ovarian tumor. Pelvic examination, ultrasonography and computed tomography scan revealed a 5-cm, cystic ovarian mass with calcification and fat component, and tumor markers were as follows, cancer antigen (CA) 125; 10.4 U/mL, CA19-9; 2 U/mL. Laparoscopy was performed. The mass was identified in the left adnexal region without any ligamentous or direct connection with the pelvic organs. The right ovary was normal. However, the left ovary and the tube could not be identified in its proper anatomical location. The mass was successfully removed with sharp and blunt dissection. A review of histopathologic study revealed a MCT. The patient became pregnant within seven months and gave birth to a healthy baby by cesarean section. We present a rare case of an autoamputated ovary with MCT.
Adult ; Amputation ; Biomarkers, Tumor ; Cesarean Section ; Dermoid Cyst ; Female ; Gynecological Examination ; Humans ; Laparoscopy ; Ligaments ; Ovarian Neoplasms ; Ovary* ; Parturition ; Pregnancy ; Prevalence ; Teratoma* ; Ultrasonography

Neonatal hydrocolpos is a rare condition that involves fluid accumulation in the vagina. On diagnostic imaging, the dilated vagina, along with the compressed uterus, can simulate a mature cystic teratoma with a mural nodule. Herein, we report the case of a newborn girl with congenital hydrocolpos that was caused by an imperforate hymen; the hydrocolpos mimicking a mature cystic teratoma on abdominal ultrasonography and magnetic resonance imaging. Any newborn girl with a pelvic cystic mass should be suspected as having a congenital vaginal obstruction manifesting as hydrocolpos or hydrometrocolpos. Thorough examination of the external genitalia, as well as imaging of the uterus and vagina, enables correct diagnosis and optimal treatment.
Diagnosis ; Diagnostic Imaging ; Female ; Genitalia ; Humans ; Hydrocolpos* ; Hymen ; Infant ; Infant, Newborn ; Magnetic Resonance Imaging ; Pelvis* ; Teratoma* ; Ultrasonography ; Uterus ; Vagina

Epignathus is an extremely rare type of congenital teratoma arising in the oral cavity. Although it is a benign tumor, it is associated with high mortality and morbidity rates because of severe airway obstruction and other malformations. We present a case of epignathus affecting one fetus in a twin pregnancy. The tumor was associated with multiple congenital malformations including cleft palate, bifid tongue, bifid uvula, congenital heart defect, and bilateral inguinal hernias. The diagnostic value of three-dimensional ultrasonography and magnetic resonance imaging was explored with respect to antenatal counseling and peripartum management.
Airway Obstruction ; Cleft Palate ; Counseling ; Fetus* ; Heart Defects, Congenital ; Hernia, Inguinal ; Magnetic Resonance Imaging* ; Mortality ; Mouth ; Peripartum Period ; Pregnancy, Twin* ; Prenatal Diagnosis* ; Teratoma ; Tongue ; Ultrasonography* ; Uvula

The ex utero intrapartum treatment (EXIT) is used for unborn fetuses in cases of predictable complications of postpartum airway obstruction. The delivered fetus is maintained on placental circulation while airway is established and this is carried out by a multidisciplinary team. Teratomas arising from the palate or pharynx may cause immediate life-threatening airway obstruction to the newborn. In our case, congenital oral teratoma was detected via prenatal ultrasound. The treating team determined that this may induce airway occlusion at birth and decided to perform an EXIT to secure an airway. On the day of birth, debulking of the tumor was performed and the fetus was successfully delivered. Vital signs were stable without intubation management.
Airway Obstruction ; Fetus ; Humans ; Infant, Newborn ; Intubation ; Palate ; Parturition ; Pharynx ; Placental Circulation ; Postpartum Period ; Teratoma* ; Ultrasonography ; Vital Signs

A mature teratoma is a tumor composed of normal derivatives of all three germ layers, and usually occurs in ovaries, testes, or mediastinum. Mature teratoma of the gastrointestinal tract occurs less frequently, and case reports of primary mature teratoma of the rectum have not been published much. Here, we report a 65-year-old woman patient presented with lower abdominal discomfort. Colonoscopy revealed a pedunculated polypoid tumor arising from the rectum with hairs on its surface, and endoscopic ultrasound revealed an exophytic pattern bulging from the serosa. The tumor was removed surgically and confirmed histologically as a benign, primary mature teratoma of the rectum.
Aged ; Colonoscopy ; Female ; Gastrointestinal Tract ; Germ Layers ; Hair ; Humans ; Mediastinum ; Ovary ; Rectum* ; Serous Membrane ; Teratoma* ; Testis ; Ultrasonography

Struma ovarii is a rare, monodermal and highly specialized teratoma, composed entirely or predominantly (>50%) of thyroid tissue. Presenting symptoms are not specific. Despite containing thyroid tissue, only 5% of struma ovarii have features of hyperthyroidism. Therefore, preoperative diagnosis of struma ovarii is difficult. Recently, the authors experienced a case of struma ovarii found in a young woman who presented with known pelvic mass and dysmenorrhea. A transabdominal ultrasonography and computed tomography detected a 16-cm sized multiloculated mass in pelvic cavity. She underwent laparoscopic unilateral ovarian wedge resection. The final histopathologic diagnosis was struma ovarii of the mature cystic teratoma. Therefore, we report this rare case with a brief review of the literature.
Diagnosis ; Dysmenorrhea ; Female ; Humans ; Hyperthyroidism ; Struma Ovarii* ; Teratoma ; Thyroid Gland ; Ultrasonography