Abstract
Cervical and parapharyngeal teratomas are rare but possible causes for respiratory distress in neonates. They can also present as cystic masses in the neck and can be clinically indistinguishable from lymphatic malformations. Physicians must be cognizant of teratoma as an alternate diagnosis when faced with cystic neck lesion that responds poorly to injection sclerotherapy. We present a case of a parapharyngeal teratoma which was initially diagnosed and treated as a lymphatic malformation.
Highlights
Teratomas are the most common congenital tumours with elements derived from all three germ cell lineages in various degrees of differentiation
Physicians must be cognizant of teratoma as an alternate diagnosis when faced with a cystic neck lesion that responds poorly to injection sclerotherapy
We present a case of a parapharyngeal teratoma which was initially diagnosed and treated as a lymphatic malformation
Summary
Teratomas are the most common congenital tumours with elements derived from all three germ cell lineages in various degrees of differentiation They can be found in different locations throughout the body but are uncommon in the head and neck region [1]. The initial Magnetic Resonance Imaging (MRI) scan showed a large cystic mass extending from the skull base to cricoid suggestive of a lymphatic malformation (Figure 1). A repeat MRI scan was performed, again showing a large multi-cystic parapharyngeal lesion causing mass effect but without intracranial extension (Figure 2). At this stage, diagnosis of teratoma was considered as a high possibility. In addition to glial tissue, the specimen sections showed mature adipose tissue, bone with marrow elements, stratified squamous epithelium and skin adnexal structures, respiratory mucosa and focal choroid plexus and cerebellar tissue-features not seen in the previous biopsy
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