Thyroid teratoma in a newborn

Abstract

A newborn girl presenting with respiratory distress soon after birth was found to have a neck mass and required transfer to a paediatric intensive care unit with neonatal expertise. She subsequently underwent endoscopic airway assessment with microlaryngoscopy and bronchoscopy proceeding to open excision of the lesion in the right thyroid lobe on day thirteen of life, resulting in resolution of airway compromise and complete pathological clearance. The baby was discharged 10 days after surgery. Histology confirmed a thyroid teratoma. At 12 months, the child was thriving with no evidence of recurrence. This case illustrates a rare but serious diagnosis that, if not managed in a timely manner, can lead to significant morbidity and mortality.

Keywords: otolaryngology / ENT; paediatric intensive care; paediatric surgery.

Figure 1

Preoperative MRI with contrast demonstrating the cervical mass in axial, coronal and sagittal section.

Figure 2

Two intraoperative endoscopic images taken at MLB prior to excision of the cervical mass, at glottic level and in subglottis, showing partial airway obstruction secondary to extrinsic tracheal compression extending from subglottis to mid tracheal level. MLB, microlaryngoscopy and bronchoscopy.

Figure 3

Intraoperative photograph demonstrating the right thyroid mass delivered through the surgical incision prior to excision.

Figure 4

Two intraoperative endoscopic images taken at MLB after excision of the cervical mass, showing resolution of airway obstruction. MLB, microlaryngoscopy and bronchoscopy.