Nasopharyngeal teratomas, as in our case, are associated with an exceptionally high risk of neonatal mortality, particularly from airway obstruction. Polyhydramnios, hydrops, and cleft palate may also occur. Other tumors, such as pure oral teratomas, have also been reported. Of 15 reported cases of pure oral teratomas, fetal death occurred in 2 cases, 1 patient terminated the pregnancy, 2 other patients had cleft palate, and 1 neonate had nerve palsy. Prior to the year 2000, this type of tumor was considered essentially incompatible with life. In fact, a review article in 2008 stated that only 8 cases existed in which the teratoma had been successfully excised.
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Our case suggests that in utero fetoscopic management of fetuses with oral teratomas may be feasible in selected cases. In utero endoscopic assessment or treatment may allow parents to make a better educated decision about their management of the pregnancy. If done early enough, as in our case, fetoscopic removal of the teratoma may avoid further growth of the mass, distortion of the facial structures, micrognathia, development of polyhydramnios, airway obstruction, the need for an EXIT or OOPS procedure, and the need for cesarean section delivery.