Beyond the Crib: Unraveling the Enigma of Neonatal Nasopharyngeal Mass

Abstract

Germ cell tumours that develop at birth are rare, with teratomas most frequently occurring in the sacrococcygeal area. Nasopharyngeal teratomas are also rare, occurring in less than 10% of head and neck teratomas. Immature Nasopharyngeal Teratoma (INT) in neonates presents a rare yet challenging clinical scenario. It can manifest with significant respiratory distress and airway compromise, necessitating prompt recognition and intervention. Diagnostic modalities such as imaging studies and biopsy aid in accurate diagnosis and treatment planning. Surgical resection remains the cornerstone of management, with complete excision being essential to optimise outcomes. The present case report highlights the importance of multidisciplinary collaboration and continued research efforts to refine therapeutic approaches and improve patient outcomes. Here, the authors present a rare case of INT in a 51-day-old male child. A 51-day-old male child, normal vaginal delivery and cried immediately after birth with complaints of respiratory distress from 8th day of life, for which he was treated with antibiotics and started on mechanical ventilation. In view of failure of extubation, bronchoscopy was done which revealed a nasopharyngeal mass. Magnetic Resonance Imaging (MRI) showed a heterogeneous mass measuring 2.3×3.9×3.1 cm (anteroposterior x transverse x craniocaudal) involving the parapharyngeal space and carotid space, extending into the retropharyngeal space, with no evidence of intracranial extension. Histopathology showed features of an immature solid teratoma. Nasopharyngeal teratomas are extremely rare congenital tumours, with only a few cases reported in the medical literature. INT in neonates represents a rare yet clinically significant entity that requires prompt recognition and intervention. Multidisciplinary collaboration and comprehensive management strategies are essential to optimise outcomes for affected neonates.