Congenital dyspneic cervical teratoma in Algeria: a case report

Cervical teratomas are rare congenital tumors that can cause life-threatening neonatal airway obstruction. Early diagnosis and multidisciplinary management are critical for improving outcomes. This case report highlights the diagnostic and therapeutic challenges in managing a rare embryonal tumor, emphasizing clinical decision-making and outcomes. We report the case of a full-term Algerian male newborn delivered via cesarean section under difficult conditions. The pregnancy was not monitored through regular antenatal care. On day 9 of life, the patient was referred for progressive respiratory distress and a large firm cervical mass. He was admitted to the neonatal intensive care unit and examined by the ENT team. Clinical evaluation revealed respiratory distress, mild cyanosis, and a firm, non-mobile cervical mass measuring approximately 25 cm, displacing the neck posteriorly. A cervical CT scan showed a large heterogeneous mass compressing the larynx and trachea, without vascular or endoluminal invasion. Emergency surgical excision was performed after a tracheotomy to secure the airway. The mass was completely removed, and histopathology confirmed an immature teratoma composed of multiple germ layer components. Despite surgical success, the patient developed persistent hemodynamic instability and died on the third postoperative day from hypovolemic shock, attributed to massive fluid shifts and metabolic imbalance. Cervical teratomas are rare but potentially life-threatening due to respiratory compromise at birth. Surgical excision is mandatory, and prenatal diagnosis is crucial to anticipate and manage airway obstruction. Prognosis largely depends on respiratory involvement and histopathological features. In our case, postoperative care in the neonatal intensive care unit was equally critical, as hemodynamic instability and metabolic complications threatened the outcome, despite successful surgery.