Perinatal management of a neonate with airway obstruction caused by rhabdomyosarcoma of the tongue

Intra-oral masses in neonates can seriously compromise the airway, potentia lly causing hypoxia and death if not recognized and managed appropriately. We report a case in which an intraoral mass was diagnosed on antenatal ultr asound scan. Preparation for delivery involved a multidisciplinary team app roach, with a strategy for management at delivery. The child was delivered by elective Caesarean section and had a patent airway. A tracheostomy was p erformed immediately after delivery. The infant underwent a debulking proce dure 3 weeks after birth. A histological diagnosis of embryonal rhabdomyosa rcoma was made and a course of chemotherapy commenced. The child had a part ial response to treatment with considerable shrinkage of the tongue mass. W e discuss the management options in neonates with intra-oral masses to prov ide an adequate airway and maintain fetal oxygenation. The differential dia gnosis of fetal oral masses is reviewed.