A Case of Mediastinal Teratoma as a Cause of Nonimmune Hydrops Fetalis, and Literature Review

Abstract

This article reviews the current literature of mediastinal tumors as the cause of nonimmune hydrops fetalis (NIHF), the outcomes of reported cases, and a general overview of NIHF including diagnosis, workup, and a management algorithm, with particular attention made to intrathoracic lesions and gestation age. We present a unique case report of a premature neonate who initially presented with NIHF at birth and was subsequently diagnosed with a germ cell mediastinal teratoma as the etiology of NIHF. The patient survived for 50 days while having undergone surgical resection and chemotherapy during the hospital course. The patient represents the first reported case of a mediastinal tumor as the etiology of NIHF in the neonatal period and only one of three cases that have been reported to survive in the neonatal period. Survival is dependent on the thoracic lesion's size, location, resectability, impact on the growth and development of other vital organs, and in the case of tumors, malignant potential. Though the combination of mediastinal teratoma and NIHF is rare, it should be included in the diagnostic evaluation of a newborn with NIHF.