Congenital teratomas of the head and neck

Objective: This article reviews teratomas, neoplasms composed of the three germinal layers of the embryo that form tissues foreign to the part in which they arise. These are most common in the sacrococcygeal region and are rare in the head and neck. In this region, major concerns are airway obstruction and cosmesis. Method: Pathology records at two tertiary care paediatric hospitals were reviewed for diagnoses of head and neck teratomas. This revealed nine cases between 1983 and 1993, five males and four females. Two males were stillborn. Five were cervical, two were in the nasopharynx, and two were facial. The lesions were immature in two cases and mature in the remainder. All of the liveborn children underwent surgery within the first year of life, and only one required tracheotomy. Results: One child had recurrence of teratomatous tissue diagnosed with CT, which was treated surgically. The child has remained free of tumour for over 3 years. Pathogenesis, clinical appearance, diagnostic work-up, and currently accepted modes of therapy are reviewed.