Outcome of prenatally diagnosed solid fetal tumors

Background/Purpose: In the last 10 years, the ability to diagnose fetal tum ors in the prenatal period has improved greatly because of technical advanc es in imaging. Early diagnosis and determination of tumor may affect progno sis. Methods: The authors retrospectively reviewed the records of 1316 fetuses w ho underwent sonographic evaluation for congenital defects at University of California-San Francisco over a 6-year period. Of these, 16 had fetal tumo rs and were followed up at our institution. There were solid or predominate ly solid with small cystic component masses in one of 3 locations: cervical , mediastinal, or abdominal. Excluded from our study were those fetuses wit h either sacrococcygeal teratoma, congenital cystic adenomatoid malformatio n of the lung, or ovarian cyst, because these defects have been extensively reviewed elsewhere. In addition, masses that were primarily cystic also we re excluded. Data collected included diagnosis, gestational age at diagnosi s and at delivery, mode of delivery, fetal and neonatal survival, and disea se confirmation. Results: Of the 16 fetuses, 4 had mediastinal tumors: 2 with pericardial te ratomas (both of whom died in utero) and 2 with cardiac rhabdomyomas (1 die d; the other presented tuberous sclerosis and is alive at 2 years of age). Four patients had cervical tumors (3 died; 1 survived and is alive and well ), and 8 had abdominal tumors (3 with liver tumors, 4 with a left adrenal m ass, and 1 with retroperitoneal teratoma). All eight patients with an abdom inal tumor are alive and well. Conclusions: Fetal tumors are rare, and the prognosis seems to depend on th eir location and size. Although easier to detect, cervical and mediastinal tumors have a worse prognosis. Abdominal masses are more difficult to detec t but have a better prognosis. J Pediatr Surg 36:1244-1247. Copyright 2001 by W.B. Saunders Company.