EP04.09: Rare case of epignathus detected by ultrasound

Here we report a case of epignathus, an extremely rare form of oropharyngeal teratoma, occurring in only 1/200,000 livebirths. A 38-year-old woman presented at 24 weeks of gestation with both low-risk Double test and non-invasive prenatal test. She has one healthy child and no spontaneous abortions. The patient itself suffers from hypothyreosis and cutaneous lupus erythematosus. Ultrasound detected a big mass originating in oral cavity with propagation in the cranium, hydrocephalus and polyhydramnion. Ultrasound sagittal section was most informative and indicated the epignathus teratoma 10x7 cm (figure 1a). The woman was given the possibility to terminate the pregnancy for medical reasons, which was done eventually. Fetal autopsy confirmed the ultrasound finding – female fetus with tumour of 190 g, dimensions 12x7x6 cm filling oral and nasal cavity, propagating to the right eye socket and middle cranial fossa (figure 1c). There was no IUGR, nor other congenital anomalies. Histopathologic analysis detected all three well-differentiated germ layers – neuroepithelial, cartilaginous, bone, fatty, connective tissue, as well as blood vessels, hepatocytes, bronchial and intestinal epithelium, glandular epithelium of endocrine pancreas and cysts with serous/mucinous content (figure 1 b). Thanks to the ultrasound the diagnosis was given on time and the further procedure was undertaken. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.