A retrospective analysis of newborns with congenital teratomas

Introduction:
The aim of this study was to analyse cases of neonates with congenital teratomas and to compare the accuracy of a prenatal teratoma suspicion with histological confirmation after birth.

Material and methods:
The authors conducted a retrospective study including 9 patients with a prenatally suspected teratoma, born and treated in the period 2019–2023 at a tertiary care hospital. Medical records of all cases were analysed and the data of 8 patients, whose diagnosis was histopathologically confirmed after birth, were included in the analysis. Information such as gender, maternal morbidities, course of pregnancy and delivery, symptoms, results of diagnostic tests, histopathological reports and postoperative complications were analysed, compared and summarised.

Results:
In all patients, the initial diagnosis was made prenatally. Each child was delivered by a caesarean section due to fetal anomalies and concomitant problems (premature rupture of membranes, mirror syndrome, chorioamnionitis, birth asphyxia). Three patients were additionally diagnosed with other congenital malformations: coarctation of the aorta, ventricular septal defect, hydrops fetalis. Six of the 8 children were operated on, and 2 died on the day of birth. A complete resection of the lesion was confirmed in 5 children, and a follow-up ultrasound was recommended for 1. A coccygectomy was performed in all patients with sacral teratomas. The average length of stay in the Neonatal Intensive Care Unit was 54 days. Of all surviving children, 1 required transport to another centre. The remaining patients were discharged home in overall good condition.

Conclusions:
Surgical resection of fetal tumours is still extremely difficult. The only chance for the child’s survival is a quick diagnosis, delivery at a tertiary referral hospital, stabilisation of the newborn at birth and surgery in the shortest possible time. If the course of pregnancy, the surgery and the postoperative period go well, the prognosis is favourable.