A full-term neonate developed acute upper airway obstruction immediately af
ter birth secondary to a polypoidal mass in the oropharynx. After the child
's airway had been secured, the mass was excised and found to be a nasophar
yngeal teratoma, a rare congenital germ cell tumour which is frequently ass
ociated with other congenital malformations. It is sometimes possible to di
agnose these tumours in utero, thereby enabling appropriate precautions to
be taken during the delivery, otherwise if the diagnosis is unknown, then i
t is essential for any attending clinician to urgently secure the airway by
means of either intubation or tracheostomy. Such a case is presented with
a review of the possible management options. This case emphasises the fact
that although many conditions are uncommon, the total incidence of rare con
ditions is surprisingly high, and that care needs to be taken at all times
in the management of patients, in order not to overlook such life-threateni
ng diagnoses. (C) 1999 Published by Elsevier Science Ireland Ltd. All right
s reserved.