Successful management of a congenital cervical teratoma exhibiting rapid growth and pharyngeal adhesion

Congenital cervical teratomas are rare anomalies that are associated with a high rate of neonatal mortality if left untreated. Perinatal airway stabilization and prompt surgical management are imperative for survival and positive long-term outcomes. Poor prenatal prognostic factors include rapid teratoma growth, airway compression, polyhydramnios, and abnormal fetal breathing. We present the case of a neonate with an exceptionally large cervical teratoma (914 ml) with laryngeal compression and dense pharyngeal adhesions. Prenatally, the teratoma exhibited a period of rapid growth, abnormal fetal breathing, and recurrent severe polyhydramnios. The fetus required an ex-utero intrapartum treatment procedure for airway stabilization. The neonate underwent a successful surgical resection at eight days of life with a multidisciplinary team that included pediatric surgery, otolaryngology, and plastic surgery. At 15 months of life, the infant is doing well at home with a gastrostomy tube and tracheostomy collar.