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Fetal Teratomas: Frequently Asked Questions

Jan 04, 2024
pregnant woman holding an ultrasound picture

A teratoma is a kind of tumor or mass called a germ cell tumor. It is made up different types of tissue, like muscle, bone or hair. A fetal teratoma is diagnosed before birth.

Q: What types of fetal teratomas are treated at Nationwide Children’s Hospital?

A: Nationwide Children’s treats all types of teratomas, such as:

  • Cervical teratoma (giant neck mass) is an abnormal growth of the neck. A cervical teratoma is a very rare tumor.
  • Sacrococcygeal teratoma (SCT) is a tumor that forms on a fetus’ tailbone, also called the coccyx. SCT is rare, occurring in about 1 in 35,000-40,000 births. They are more common in males than females.
  • Pericardial, ovarian, and other teratomas also are treated here.

A large team of specialists treat all types of teratomas in children both before and after birth.

Q: Are teratomas cancerous (malignant)?

A: Most teratomas are not cancerous (benign) but may have parts that are pre-cancerous. Your doctor may suggest having the mass removed because it could become cancerous later.

Q: What causes teratomas?

A: The cause of teratomas is not known. Doctors don’t know why they happen, but they do know that they typically come from stem cells. They are not passed on by parents, and they do not run in families.

Q: How are fetal teratomas diagnosed?

A: A fetal teratoma may be seen as a mass on an ultrasound. A blood test shows a high level of alpha-fetoprotein in the mother’s blood can also suggest a fetal teratoma may be present. An ultrasound can show where the teratoma is on the baby’s body.

Q: What happens if the medical team diagnoses a fetal teratoma?

A: Your doctor may refer you to a fetal center like Nationwide Children’s Fetal Center for evaluation and counseling by our full team of specialists. Additional tests may be ordered which may include:

  • Comprehensive ultrasound – A high-resolution 3D ultrasound to confirm the diagnosis, measure the blood flow to the tumor and look for other concerns.
  • Fetal MRI (magnetic resonance imaging):Imaging that gives more detailed pictures of the fetal organs that may not have been seen on ultrasound.
  • Fetal echocardiogram – A special ultrasound to look at how the baby’s heart looks and works, because teratomas may affect the baby’s heart function.
  • Amniocentesis/chromosome studies – A medical procedure in which a small amount of amniotic fluid is taken and studied to screen for genetic problems.

Q: How are fetal teratomas treated?

A: The pregnant parent and baby will be closely monitored by a fetal medicine specialist and fetal cardiologist during pregnancy. Prenatal care includes frequent ultrasounds to track the size and effects of the tumor, especially on the heart. The medical team will decide whether the teratoma can be safely observed and cared for after birth or if treatment is needed before birth.

Q: When is fetal intervention needed for fetal teratomas?

A: Most teratomas will need surgery to remove the mass at some point. Most commonly this can be done after birth, but sometimes treatment may be needed during the pregnancy called a “fetal intervention.” Here are some examples when fetal intervention might be done.

  • Sacrococcygeal teratomas can get so large that supplying blood to the tumor starts to put a strain on the baby’s heart to the point that the heart may fail. Removing the tumor during pregnancy (fetal surgery) can prevent heart failure and death.
  • When a pericardial teratoma (a teratoma on the coverings of the heart) is large, it can create pressure on the heart. Fluid backs up around the heart (effusion) and other parts of the body (hydrops). In that situation, removing the mass during pregnancy (fetal surgery) will prevent heart failure and death.
  • Cervical teratomas in the neck may block the baby’s airway making it difficult for the baby to breath after delivery. An ex uterointrapartum treatment (EXIT) is a procedure performed just before the baby is delivered to help the baby breathe after birth.

Q: What are the outcomes of babies with teratomas?

A: With treatment, babies born with teratomas usually do very well.

The Fetal Center at Nationwide Children's Hospital offers a team of experts focused on the treatment of infants with cervical teratomas or sacrococcygeal teratomas. Diagnoses and intervention begin before birth. The expert team evaluates and treats nearly every fetal complication, from the most common to the most complex conditions.

Featured Expert

Oluyinka O. Olutoye, MD, PhD, Surgeon-In-Chief at Nationwide Children’s Hospital
Oluyinka Olutoye, MD, PhD

Dr. Olutoye is a world-renowned fetal and neonatal surgeon bringing specialized clinical and research experience to the Fetal Center at Nationwide Children’s Hospital. His expertise enables our team to provide exceptional care for babies who need surgery in-utero and improve outcomes for a range of conditions such as congenital diaphragmatic hernia, spina bifida and other congenital anomalies.

Nationwide Children's Hospital Medical Professional
Karen Texter, MD
Director of Fetal Echocardiography

Karen M. Texter, MD, is Director of Fetal Echocardiography at The Heart Center at Nationwide Children's Hospital. Her special interests include echocardiography in congenital and acquired heart disease, and fetal cardiology.

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