SUCCESSFUL EXCISION OF A LARGE IMMATURE TERATOMA INVOLVING THE CRANIAL BASE - REPORT OF A CASE WITH LONG-TERM FOLLOW-UP

OBJECTIVE AND IMPORTANCE: Massive congenital intracranial teratomas wi th extracranial extension are rare. The prognosis in these cases has b een poor, with stillbirth or immediate postpartum death as the usual o utcome. With recent advances in fetal monitoring, neonatal care, and s urgical techniques used for the management of complex tumors of the cr anial base, some of these lesions may now be amenable to radical surgi cal resection and then immediate craniofacial reconstruction. CLINICAL PRESENTATION: A neonate with a large congenital immature teratoma inv olving the entire left side of the cranium and face was evaluated at o ur institution 1 day after birth. INTERVENTION: Total resection of the mass and then immediate reconstruction of the deformed orbit, maxilla , and mandible were performed at 9 days of age. Additional operations on the midface and mandible to allow for a functional bite were subseq uently required as the child developed during the next 2 years. Four y ears after resection, the patient exhibited a reasonable cosmetic resu lt and only mild developmental delay. CONCLUSION: We conclude that acc eptable functional and cosmetic outcomes can be achieved by early inte rvention, consisting of radical resection and immediate craniofacial r econstruction, in some neonates with massive congenital craniofacial t eratomas.