Microendoscopic transoral C0 2-laser resection of an extensive nasopharyngeal and oral teratoma

Abstract

Teratomas are congenital lesions and quite rare, particularly in the head and neck region. Only a few cases of such lesions are found in the 1iteratureY Teratomas generally occur in 1 of 4,000 births, but only 10% are found in the head and neck.3 A female predominance exists.4J Teratomas of the head and neck are frequently associated with maternal polyhydramniosis secondary to obstruction of swallowing by the tumor. Additional symptoms are enlargement of the uterus or a tendency to dystokia. Other congenital anomalies (ie, malformation of the urogenital tract, gastrointestinal tract, central nervous system, heart, musculo-skeletal system) are associated with teratomas in up to 18%.6 During early childhood, these tumors are usually benign, but the incidence of malignancy increases considerably with age. The exact origin of teratomas is unknown and is a matter of dispute. The most likely model for the pathogenesis of these tumors seems to be the development from ectopic embryogenic cells and pluripotent stem cells. During early embryogenesis in the area of the buccopharyngeal membrane, different germ layers gain an intimate neighborhood. Also during this period of development, Rathke’s pouch forms at the roof of the nasopharynx. It is well known that remnants of the anterior lobe of the hypophysis may be retained and incorporated in the body of the sphenoid. During this process, for example, parts of the