THE ULTRASONOGRAPHIC APPEARANCE AND OUTCOME FOR FETUSES WITH MASSES DISTORTING THE FETAL FACE

Our objective was to determine the appearance, cause, and outcome of f etal face masses diagnosed antenatally by ultrasonography. Over a 6 ye ar period, 10 consecutive fetuses with facial masses were identified. Ultrasonographic findings, neonatal pathologic findings, and outcome d ata were correlated. Four (40%) of the 10 fetuses died, including one with a palatal teratoma associated with a Dandy-Walker malformation an d three with intracranial teratomas-one of which was associated with h ydrops fetalis. Among the survivors, one fetus had a dacryocystocele t hat was managed conservatively and one had drainage of a salivary glan d cyst. The remaining four neonates had successful excision of their t umors in the neonatal period and survived; these infants had a nasal t eratoma, a thyroid teratoma, a gingival granular cell tumor, and a sca lp hemangioma. Four of the 10 pregnancies had associated polyhydramnio s, three of which ended in stillbirth or neonatal death. In conclusion , 40% of the fetuses with antenatal diagnosis of fetal facial masses d id not survive. If those with intracranial teratomas are removed from this group, one of seven (14%) fetuses with extracranial masses died. The intracranial teratomas were uniformly fatal. Polyhydramnios was as sociated with a poor outcome.