Giant Neck Mass (Cervical Teratoma)
A giant neck mass is an abnormal growth of the neck. There are two different types of masses including cervical teratomas and lymphatic malformations. The cause of it is unknown, but it can be treated.
What is a Giant Neck Mass?
A giant neck mass is an abnormal growth of the neck. There are two different types of masses:
- Cervical teratomas: A cervical teratoma is a very rare tumor. It is typically not cancerous and is often part solid and part fluid. These tumors can be large and cause changes to the structure of your baby’s neck and face. They can also make it hard for your baby to breathe and swallow.
- Lymphatic or vascular malformations, such as cystic hygroma or venolymphatic malformation: A lymphatic malformation is a tumor of the lymphatic system. The lymphatic system does many different jobs for your body, including being a part of your immune system. This type of tumor is typically made up of pieces of lymphatic vessels that develop abnormally. These tumors can spread to different parts of the body. In the neck, they can present as a giant mass.
What Causes a Giant Neck Mass?
The cause of a giant neck mass is unknown and appear to be random. They are not passed on by parents, and they do not run in families.
What are the Signs and Symptoms of a Giant Neck Mass?
Signs of a giant neck mass are typically seen on the routine 18-week ultrasound.
- There may be extra amniotic fluid.
- Your baby may have an empty or relatively small stomach. This could mean they cannot swallow amniotic fluid.
Your baby’s neck may be overly bent or hyperextended. The doctor might be able to see the tumor.
How is a Giant Neck Mass Diagnosed?
Diagnosis of a giant neck mass is typically done by ultrasound during pregnancy. A fetal MRI or other testing can help your doctors see if other structures are affected, such as the airway or the esophagus.
How is a Giant Neck Mass Treated?
Ultrasounds will be done on a regular basis for the rest of your pregnancy to watch the tumor’s growth and the amount of amniotic fluid.
If your baby’s airway is blocked by the tumor at the time of delivery, an ex utero intrapartum treatment (EXIT) procedure will be performed. During the EXIT procedure, you will have general anesthesia for a C-section. Your baby’s head and arms will be delivered, but the placenta and umbilical cord will stay attached so they can receive oxygen-rich blood during the procedure. This allows the doctors to find an airway so your baby can breathe after the cord is cut. Your doctor will talk to you about long-term options for your baby’s breathing and eating. They may need more than one surgery or procedure to treat their giant neck mass.
During pregnancy, the mass could block your baby’s airway and esophagus (the tube that carries food and liquids to the stomach). If the esophagus is blocked, your baby will have a hard time swallowing amniotic fluid. This could lead to too much amniotic fluid in the womb, causing preterm labor. If your baby’s airway is blocked, your baby may not be able to breathe in amniotic fluid. This could lead to underdeveloped lungs.
After birth, infants have trouble swallowing or breathing on their own, even after the tumor is removed. If this occurs, your baby will see a specialists to help treat these issues.
Finding this condition during pregnancy and treating it early increases your baby’s chances of survival. Depending on the type of neck mass and the structures involved, your baby may need more than one procedure or surgery to treat the mass or reconstruct the affected parts of the body.
In many cases, the thyroid gland is partially or fully replaced by the growth of the mass. Your baby may need to have follow-up care with an endocrinologist and take medicine for hypothyroidism.
Your baby may also have follow-up appointments, long-term, to make sure the tumor does not come back. Sometimes the tumor cannot be completely removed, but it can be treated to help with swallowing and breathing. In most cases, the tumors are not cancerous (benign), and your child can live a long life.